| Entity Name: | JAISON JOSEPH LUKE NP PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 31 Jan 2023 (2 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 07 Nov 2024 (3 months ago) |
| Document Number: | P23000009539 |
| FEI/EIN Number | 92-2313430 |
| Address: | 17245 OLD TOBACCO ROAD, LUTZ, FL, 33558, US |
| Mail Address: | 17245 OLD TOBACCO ROAD, LUTZ, FL, 33558, US |
| ZIP code: | 33558 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285404939 | 2024-01-04 | 2024-01-07 | 17245 OLD TOBACCO RD, LUTZ, FL, 335584947, US | 17245 OLD TOBACCO RD, LUTZ, FL, 335584947, US | |||||||||||||
|
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| Phone | +1 407-729-4298 |
Authorized person
| Name | JAISON JOSEPH LUKE |
| Role | PRESIDENT |
| Phone | 4077294298 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JOSEPH LUKE JAISON | Agent | 17245 OLD TOBACCO ROAD, LUTZ, FL, 33558 |
| Name | Role | Address |
|---|---|---|
| JOSEPH LUKE JAISON | President | 17245 OLD TOBACCO ROAD, LUTZ, FL, 33558 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000023136 | STARLIGHT HEALTH | ACTIVE | 2024-02-10 | 2029-12-31 | No data | 17245 OLD TOBACCO ROAD, LUTZ, FL, 33558 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-11-07 | JOSEPH LUKE, JAISON | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-11-07 |
| Domestic Profit | 2023-01-31 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
