| Entity Name: | THE ROOT CAUSE MEDICAL CLINIC INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 08 Jun 2016 (9 years ago) |
| Date of dissolution: | 31 Mar 2017 (8 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 31 Mar 2017 (8 years ago) |
| Document Number: | P16000050446 |
| FEI/EIN Number | 81-2877094 |
| Address: | 15049 BRUCE B DOWNS, TAMPA, FL 33647 |
| Mail Address: | 5947 OLD BERKLEY RD, AUBURNDALE, FL 33823 |
| ZIP code: | 33647 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962854802 | 2016-07-04 | 2023-02-23 | 15049 BRUCE B DOWNS BLVD, TAMPA, FL, 336471388, US | 15049 BRUCE B DOWNS BLVD, TAMPA, FL, 336471388, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 937-216-9048 |
| Fax | 8448283997 |
Authorized person
| Name | JORDAN MATTHEW AXE |
| Role | OWNER/PRESIDENT |
| Phone | 9372169048 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | No |
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | No |
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LG0600X - Gerontology Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| AXE, JORDAN | Agent | 5947 OLD BERKLEY RD, AUBURNDALE, FL 33823 |
| Name | Role | Address |
|---|---|---|
| AXE, JORDAN | President | 5947 OLD BERKLEY RD, AUBURNDALE, FL 33823 UN |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2017-03-31 | No data | CONVERSION MEMBER. RESULTING CORPORATION WAS L17000079906. CONVERSION NUMBER 500000170325 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-03-31 |
| Domestic Profit | 2016-06-08 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
