| Entity Name: | PAUL D. JAYACHANDRA, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
PAUL D. JAYACHANDRA, M.D., P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 17 Mar 1999 (26 years ago) |
| Document Number: | P99000026368 |
| FEI/EIN Number |
593573936
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1680 OSCEOLA ELEM SCHOOL RD, STE A, SAINT AUGUSTINE, FL, 32084 |
| Mail Address: | 1680 OSCEOLA ELEM SCHOOL RD, STE A, SAINT AUGUSTINE, FL, 32084 |
| ZIP code: | 32084 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1295870830 | 2007-02-21 | 2007-10-22 | 1680 OSCEOLA ELEMENTARY SCHOOL ROAD, SUITE A, ST AUGUSTINE, FL, 32084, US | 1680 OSCEOLA ELEMENTARY SCHOOL ROAD, SUITE A, ST AUGUSTINE, FL, 32084, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-824-7476 |
| Fax | 9048247870 |
Authorized person
| Name | JENNIFER RAE FAIRCLOTH |
| Role | OFFICE MANAGER |
| Phone | 9048247476 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME0066989 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS FLORIDA |
| Number | 26220 |
| State | FL |
| Issuer | MEDICARE PROVIDER NUMBER |
| Number | 26220Y |
| State | FL |
| Issuer | AETNA |
| Number | 5777008 |
| State | FL |
| Issuer | WAUSA BENIFITS |
| Number | 94163841 |
| State | FL |
| Issuer | MEDICARE PTAN |
| Number | AA919 |
| State | FL |
| Issuer | AVMED |
| Number | 206068 |
| State | FL |
| Issuer | MEDICAID |
| Number | 376531801 |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | 390006717 |
| State | FL |
| Issuer | UNITED HEALTHCARE |
| Number | 110132302 |
| State | FL |
| Issuer | MEDICARE PTAN NUMBER |
| Number | 26220Y |
| State | FL |
| Issuer | WELLCARE |
| Number | 150095 |
| State | FL |
| Issuer | HEALTHEASE |
| Number | 150095 |
| State | FL |
| Issuer | MEDICAID |
| Number | 376531800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JAYACHANDRA PAUL D | Treasurer | 1680 OSCEOLA ELEM SCHOOL RD STE A, SAINT AUGUSTINE, FL, 32084 |
| JAYACHANDRA PAUL D | President | 1680 OSCEOLA ELEM SCHOOL RD STE A, SAINT AUGUSTINE, FL, 32084 |
| JAYACHANDRA PAUL D | Secretary | 1680 OSCEOLA ELEM SCHOOL RD STE A, SAINT AUGUSTINE, FL, 32084 |
| JAYACHANDRA PAUL D | Director | 1680 OSCEOLA ELEM SCHOOL RD STE A, SAINT AUGUSTINE, FL, 32084 |
| FARAH LAW | Agent | 6550 ST. AUGUSTINE ROAD, JACKSONVILLE, FL, 32217 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2021-02-26 | FARAH LAW | - |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-26 | 6550 ST. AUGUSTINE ROAD, Suite 103, JACKSONVILLE, FL 32217 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2002-05-27 | 1680 OSCEOLA ELEM SCHOOL RD, STE A, SAINT AUGUSTINE, FL 32084 | - |
| CHANGE OF MAILING ADDRESS | 2002-05-27 | 1680 OSCEOLA ELEM SCHOOL RD, STE A, SAINT AUGUSTINE, FL 32084 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-03-09 |
| ANNUAL REPORT | 2021-02-26 |
| ANNUAL REPORT | 2020-04-07 |
| ANNUAL REPORT | 2019-03-05 |
| ANNUAL REPORT | 2018-03-22 |
| ANNUAL REPORT | 2017-03-16 |
| ANNUAL REPORT | 2016-03-25 |
| ANNUAL REPORT | 2015-02-25 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
