| Entity Name: | COASTAL INTERNAL MEDICINE SPECIALISTS, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 27 Nov 2001 (23 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | L01000006940 |
| FEI/EIN Number | 593757787 |
| Address: | 335 CLYDE MORRIS BLVD., SUITE 290, ORMOND BEACH, FL, 32174 |
| Mail Address: | 335 CLYDE MORRIS BLVD., SUITE 290, ORMOND BEACH, FL, 32174 |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699950493 | 2007-12-31 | 2008-09-16 | 335 CLYDE MORRIS BLVD, SUITE 290, ORMOND BEACH, FL, 321743114, US | 335 CLYDE MORRIS BLVD, SUITE 290, ORMOND BEACH, FL, 321743114, US | |||||||||||||||||||
|
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| Phone | +1 386-672-3219 |
| Fax | 3866723160 |
Authorized person
| Name | DR. MICHAEL E TOWNSEND |
| Role | PRESIDENT |
| Phone | 3866723219 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME00611433 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TOWNSEND MICHAEL | Agent | 335 CLYDE MORRIS BLVD, ORMOND BEACH, FL, 32174 |
| Name | Role | Address |
|---|---|---|
| TOWNSEND MICHAEL E | President | 335 CLYDE MORRIS, SUITE 290, ORMOND BEACH, FL, 32174 |
| Name | Role | Address |
|---|---|---|
| LASTARZA MARK W | Treasurer | 335 CLYDE MORRIS BLVD, SUITE 290, ORMOND BEACH, FL, 32174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-01-19 | 335 CLYDE MORRIS BLVD., SUITE 290, ORMOND BEACH, FL 32174 | No data |
| CHANGE OF MAILING ADDRESS | 2012-01-19 | 335 CLYDE MORRIS BLVD., SUITE 290, ORMOND BEACH, FL 32174 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-01-19 | TOWNSEND, MICHAEL | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-01-19 | 335 CLYDE MORRIS BLVD, SUITE 290, ORMOND BEACH, FL 32174 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-04-15 |
| ANNUAL REPORT | 2014-02-11 |
| ANNUAL REPORT | 2013-05-03 |
| ANNUAL REPORT | 2012-01-19 |
| ANNUAL REPORT | 2011-02-17 |
| ANNUAL REPORT | 2010-04-14 |
| ANNUAL REPORT | 2009-03-31 |
| ANNUAL REPORT | 2008-05-01 |
| ANNUAL REPORT | 2007-04-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
