| Entity Name: | JADE CLINIC FAMILY AND WELLNESS CENTER CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Apr 2021 (4 years ago) |
| Document Number: | P21000035994 |
| FEI/EIN Number | 86-3233382 |
| Address: | 2665 CLEVELAND AVENUE, SUITE 208, FORT MYERS, FL, 33901 |
| Mail Address: | 2665 CLEVELAND AVENUE, SUITE 208, FORT MYERS, FL, 33901 |
| ZIP code: | 33901 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912587825 | 2021-04-13 | 2021-08-30 | 2665 CLEVELAND AVE STE 208, FORT MYERS, FL, 339015850, US | 2665 CLEVELAND AVE STE 208, FORT MYERS, FL, 339015850, US | |||||||||||||||||||
|
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| Phone | +1 239-839-1950 |
| Fax | 2392361665 |
Authorized person
| Name | MRS. TERESA D DAMERA |
| Role | APRN |
| Phone | 7864750034 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DAMERA TERESA D | Agent | 2665 CLEVELAND AVENUE, FORT MYERS, FL, 33901 |
| Name | Role | Address |
|---|---|---|
| DAMERA TERESA D | President | 2665 CLEVELAND AVENUE, SUITE 208, FORT MYERS, FL, 33901 |
| Name | Role | Address |
|---|---|---|
| MOLINA CARL | Vice President | 2665 CLEVELAND AVENUE, SUITE 208, FORT MYERS, FL, 33901 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-13 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-03-21 |
| Domestic Profit | 2021-04-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
