| Entity Name: | ST. AUGUSTINE MEDICAL EQUIPMENT, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 15 Apr 2002 (23 years ago) |
| Date of dissolution: | 22 Aug 2013 (11 years ago) |
| Last Event: | LC VOLUNTARY DISSOLUTION |
| Event Date Filed: | 22 Aug 2013 (11 years ago) |
| Document Number: | L02000009157 |
| FEI/EIN Number | 01-0679219 |
| Address: | 105 SOUTHPARK BLVD, A101, SAINT AUGUSTINE, FL 32086 |
| Mail Address: | 925 BAYSIDE BLUFF RD., JACKSONVILLE, FL 32259 |
| ZIP code: | 32086 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467532697 | 2006-10-16 | 2011-12-13 | 105 SOUTHPARK BLVD, STE A101, ST AUGUSTINE, FL, 32086, US | 105 SOUTHPARK BLVD, STE A101, ST AUGUSTINE, FL, 32086, US | |||||||||||||||||||||||||||||||
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| Phone | +1 904-829-1799 |
| Fax | 9048290549 |
Authorized person
| Name | MR. BRIAN S KAMAN |
| Role | OWNER PARTNER |
| Phone | 9048291799 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 1689 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025524600 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | R9312 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TANTON, DANNY | Agent | 925 BAYSIDE BLUFF RD., JACKSONVILLE, FL 32259 |
| Name | Role | Address |
|---|---|---|
| KAMAN, BRIAN S | Managing Member | 144 SUMMERHILL CIRCLE, SAINT AUGUSTINE, FL 32086 |
| TANTON, DANNY D | Managing Member | 925 BAYSIDE BLUFF, JACKSONVILLE, FL 32259 |
| BURGHARDT, JOSEPH P | Managing Member | 1437 HOPKINS CREEK LN., NEPTUNE BEACH, FL 32266 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC VOLUNTARY DISSOLUTION | 2013-08-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-02-01 | 105 SOUTHPARK BLVD, A101, SAINT AUGUSTINE, FL 32086 | No data |
| Name | Date |
|---|---|
| LC Voluntary Dissolution | 2013-08-22 |
| ANNUAL REPORT | 2013-01-19 |
| ANNUAL REPORT | 2012-01-06 |
| ANNUAL REPORT | 2011-01-11 |
| ANNUAL REPORT | 2010-01-23 |
| ANNUAL REPORT | 2009-01-27 |
| ANNUAL REPORT | 2008-02-01 |
| ANNUAL REPORT | 2007-01-31 |
| ANNUAL REPORT | 2006-03-30 |
| ANNUAL REPORT | 2005-01-31 |
Date of last update: 31 Jan 2025
Sources: Florida Department of State
