| Entity Name: | JEFFREY T. BEAMS, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 09 Apr 1998 (27 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | P98000032556 |
| FEI/EIN Number | 593521709 |
| Address: | Lowell Correctional Facility, 11120 NW Gainesville Rd, Ocala, FL, 34482-1479, US |
| Mail Address: | 8801 Hunters Lake Dr, Tampa, FL, 33647, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972908994 | 2014-11-03 | 2014-11-03 | 10929 N 56TH ST, TEMPLE TERRACE, FL, 336173000, US | 10929 N 56TH ST, TEMPLE TERRACE, FL, 336173000, US | |||||||||||||||||||||||||
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| Phone | +1 813-513-3095 |
| Fax | 9135133097 |
Authorized person
| Name | DR. JEFFREY THOMAS BEAMS |
| Role | OWNER |
| Phone | 8135133095 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | OS7230 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 255455100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PINA OLGA M | Agent | 501 E KENNEDY BLVD, STE 1700, TAMPA, FL, 33602 |
| Name | Role | Address |
|---|---|---|
| Beams JEFFREY TDr. | President | 8801 Hunters Lake Dr, Tampa, FL, 33647 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-14 | Lowell Correctional Facility, 11120 NW Gainesville Rd, Ocala, FL 34482-1479 | No data |
| CHANGE OF MAILING ADDRESS | 2021-02-15 | Lowell Correctional Facility, 11120 NW Gainesville Rd, Ocala, FL 34482-1479 | No data |
| CANCEL ADM DISS/REV | 2009-11-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| REINSTATEMENT | 2004-04-29 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J17000177081 | TERMINATED | 1000000738494 | HILLSBOROU | 2017-03-22 | 2027-03-30 | $ 876.52 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, TAMPA SERVICE CENTER, 6302 E DR MARTIN LUTHER KING JR BLVD S, TAMPA FL336191166 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-03-14 |
| ANNUAL REPORT | 2021-02-15 |
| ANNUAL REPORT | 2020-01-22 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-01-12 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-07-26 |
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-04-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
