| Entity Name: | AMP ORAL AND MAXILLOFACIAL SURGERY, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 31 Jul 2019 (6 years ago) |
| Document Number: | P19000061902 |
| FEI/EIN Number | 84-2584742 |
| Address: | 10524 MOSS PARK ROAD, SUITE 204-616, ORLANDO, FL 32832 |
| Mail Address: | 10524 MOSS PARK ROAD, SUITE 204-616, ORLANDO, FL 32832 |
| ZIP code: | 32832 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144812348 | 2021-02-09 | 2024-04-22 | 10524 MOSS PARK RD STE 204-616, ORLANDO, FL, 328325898, US | 3861 AVALON PARK EAST BLVD, ORLANDO, FL, 328284853, US | |||||||||||||||
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| Phone | +1 678-480-9808 |
| Phone | +1 407-544-0139 |
Authorized person
| Name | DR. JONATHAN CLINTON ELMORE |
| Role | OWNER/AUTHORIZED OFFICIAL |
| Phone | 6784809808 |
Taxonomy
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ELMORE, JONATHAN C | Agent | 10524 MOSS PARK ROAD, SUITE 204-616, ORLANDO, FL 32832 |
| Name | Role | Address |
|---|---|---|
| Elmore, Jonathan C | President | 10524 Moss Park Road, 204-616 Orlando, FL 32832 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-08 |
| ANNUAL REPORT | 2024-02-20 |
| ANNUAL REPORT | 2023-01-05 |
| ANNUAL REPORT | 2022-01-08 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-04-18 |
| Domestic Profit | 2019-07-31 |
Date of last update: 16 Feb 2025
Sources: Florida Department of State
