| Entity Name: | MISS CENTER OF EXCELLENCE PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 27 Dec 2021 (3 years ago) |
| Document Number: | P22000000835 |
| FEI/EIN Number | 87-4332923 |
| Address: | 14105 W M DAVIS PARKWAY, 9, JACKSONVILLE, FL, 32224, US |
| Mail Address: | 14286 Beach Blvd, 19204, JACKSONVILLE, FL, 32250, US |
| ZIP code: | 32224 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588319925 | 2022-02-15 | 2022-02-15 | 4530-15 ST JOHNS AVENUE 396, 396, JACKSONVILLE, FL, 32210, US | 4530-15 ST JOHNS AVENUE 396, 396, JACKSONVILLE, FL, 32210, US | |||||||||||||
|
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| Phone | +1 904-451-7144 |
Authorized person
| Name | ANDREW F CANNESTRA |
| Role | OWNER |
| Phone | 9043431185 |
Taxonomy
| Taxonomy Code | 207T00000X - Neurological Surgery Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| BLUE FURY CONSULTING, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| Cannestra Andrew | President | 14286 Beach Blvd, JACKSONVILLE, FL, 32250 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000155885 | MISS CENTER OF EXCELLENCE P.C. | ACTIVE | 2022-12-19 | 2027-12-31 | No data | 4530-15 ST JOHNS AVENUE, JACKSONVILLE, FL, 32210 |
| G22000155894 | MINIMALLY INVASIVE SPINAL SURGERY CENTER OF EXCELLENCE | ACTIVE | 2022-12-19 | 2027-12-31 | No data | 4530-15 ST JOHNS AVENUE, #296, JACKSONVILLE, FL, 32210 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-04-23 | 14105 W M DAVIS PARKWAY, 9, JACKSONVILLE, FL 32224 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-23 | 14286 Beach Blvd, 19204, JACKSONVILLE, FL 32250 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-23 |
| Domestic Profit | 2021-12-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
