| Entity Name: | BROC FLORES, DMD, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 06 Oct 2022 (2 years ago) |
| Document Number: | P22000076971 |
| FEI/EIN Number | 920612413 |
| Address: | 5911 TIMUQUANA RD., SUITE 202, JACKSONVILLE, FL, 32210, US |
| Mail Address: | 5911 TIMUQUANA RD., SUITE 202, JACKSONVILLE, FL, 32210, US |
| ZIP code: | 32210 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043935596 | 2022-10-06 | 2022-10-06 | 1592 GLENDALE ST, JACKSONVILLE, FL, 322058925, US | 5911 TIMUQUANA RD STE 202, JACKSONVILLE, FL, 322108174, US | |||||||||||||
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| Phone | +1 904-553-8114 |
Authorized person
| Name | BROC FLORES |
| Role | OWNER |
| Phone | 9045538114 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FLORES BROC | Agent | 5911 TIMUQUANA RD., JACKSONVILLE, FL, 32210 |
| Name | Role | Address |
|---|---|---|
| FLORES BROC | President | 4630 Arlon Ln, JACKSONVILLE, FL, 32210 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000155329 | ORTEGA DENTAL | ACTIVE | 2022-12-16 | 2027-12-31 | No data | 5911 TIMUQUANA RD, STE 202, JACKSONVILLE, FL, 32210 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-26 | 5911 TIMUQUANA RD., SUITE 202, JACKSONVILLE, FL 32210 | No data |
| CHANGE OF MAILING ADDRESS | 2023-10-04 | 5911 TIMUQUANA RD., SUITE 202, JACKSONVILLE, FL 32210 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| ANNUAL REPORT | 2023-03-03 |
| Domestic Profit | 2022-10-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
