| Entity Name: | HYDE PARK MEDICAL ARTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Oct 1998 (26 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 05 Nov 2019 (5 years ago) |
| Document Number: | P98000089746 |
| FEI/EIN Number | 593538593 |
| Address: | 1634 Blanding Boulevard, Jacksonville, FL, 32210, US |
| Mail Address: | 1634 Blanding Boulevard, Jacksonville, FL, 32210, US |
| ZIP code: | 32210 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235286527 | 2007-01-05 | 2012-12-17 | 6671 HYDE GROVE AVE, JACKSONVILLE, FL, 322102839, US | 6671 HYDE GROVE AVE, JACKSONVILLE, FL, 322102839, US | |||||||||||||||||||||||||
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| Phone | +1 904-783-3700 |
| Fax | 9046952579 |
Authorized person
| Name | MS. REBECCA JANE HAYNES |
| Role | OFFICE MANAGER |
| Phone | 9047833700 |
Taxonomy
| Taxonomy Code | 207QS0010X - Sports Medicine (Family Medicine) Physician |
| License Number | OS7282 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 264729000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LAMOUNETTE ROBERT G | Agent | 4557 Bass Place South, Jacksonville, FL, 32210 |
| Name | Role | Address |
|---|---|---|
| LAMOUNETTE ROBERT GDr. | Director | 4557 Bass Place South, Jacksonville, FL, 32210 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000134123 | HYDE PARK CHIROPRACTIC CENTER | ACTIVE | 2023-11-01 | 2028-12-31 | No data | 1634 BLANDING BLVD, JACKSONVILLE, FL, 32210 |
| G21000135688 | HYDE GROVE MEDICAL BUILDING | ACTIVE | 2021-10-08 | 2026-12-31 | No data | 6671 HYDE GROVE AVENUE, JACKSONVILLE, FL, 32210 |
| G03057700199 | HYDE PARK MEDICAL CENTER | EXPIRED | 2003-02-26 | 2024-12-31 | No data | 6671 HYDE GROVE AVENUE, JACKSONVILLE, FL, 32210-2839 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-09 | 1634 Blanding Boulevard, Jacksonville, FL 32210 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-09 | 1634 Blanding Boulevard, Jacksonville, FL 32210 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-09 | LAMOUNETTE, ROBERT G. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-09 | 4557 Bass Place South, Jacksonville, FL 32210 | No data |
| REINSTATEMENT | 2019-11-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| AMENDED AND RESTATEDARTICLES/NAME CHANGE | 1998-11-23 | HYDE PARK MEDICAL ARTS, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-04-09 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-05-04 |
| ANNUAL REPORT | 2020-06-19 |
| REINSTATEMENT | 2019-11-05 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-04-10 |
| ANNUAL REPORT | 2016-04-05 |
| ANNUAL REPORT | 2015-01-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
