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  5. FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC

FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC

Company Details

Entity Name: FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 12 Jun 2003 (22 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 17 May 2021 (4 years ago)
Document Number: L03000021320
FEI/EIN Number 54-2113873
Address: 425 W. Colonial Dr, Ste 303, Orlando, FL 32804
Mail Address: 425 W. Colonial Dr, Ste 303, Orlando, FL 32804
ZIP code: 32804
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1417559147 2020-11-09 2023-07-12 6900 TAVISTOCK LAKES BLVD STE 300, ORLANDO, FL, 328277592, US 1215 DUNN AVE, JACKSONVILLE, FL, 322186330, US

Contacts
Phone +1 904-745-3618
Fax 9047224271
Phone +1 904-757-1998
Fax 9046967462

Authorized person
Name DOUG MALTON
Role CFO
Phone 8333093737

Taxonomy
Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAMILY CARE PARTNERS OF NORTHEAST FLORIDA WELFARE BENEFITS PLAN 2020 542113873 2021-06-07 FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC 128
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2001-03-01
Business code 621111
Sponsor’s telephone number 9047453618
Plan sponsor’s mailing address 6520 FORT CAROLINE RD, JACKSONVILLE, FL, 322772044
Plan sponsor’s address 6520 FORT CAROLINE RD, JACKSONVILLE, FL, 322772044

Number of participants as of the end of the plan year
Active participants 128

Signature of
Role Plan administrator
Date 2021-06-07
Name of individual signing MERIDETH CREECY
Valid signature Filed with authorized/valid electronic signature
FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC EMPLOYEES SAVINGS AND RETIREMENT PLAN 2019 542113873 2020-10-15 FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC 367
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-06-01
Business code 621111
Sponsor’s telephone number 9047447300
Plan sponsor’s mailing address 6484 FORT CAROLINE RD, JACKSONVILLE, FL, 322772042
Plan sponsor’s address 6484 FORT CAROLINE RD, JACKSONVILLE, FL, 322772042

Number of participants as of the end of the plan year
Active participants 353
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 41
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 90
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 5

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing DANIELLE DYER-TYLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-15
Name of individual signing DANIELLE DYER-TYLER
Valid signature Filed with authorized/valid electronic signature
FAMILY CARE PARTNERS OF NORTHEAST FLORIDA WELFARE BENEFITS PLAN 2019 542113873 2021-06-07 FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC 128
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2001-03-01
Business code 621111
Sponsor’s telephone number 9047453618
Plan sponsor’s mailing address 6520 FORT CAROLINE RD, JACKSONVILLE, FL, 322772044
Plan sponsor’s address 6520 FORT CAROLINE RD, JACKSONVILLE, FL, 322772044

Number of participants as of the end of the plan year
Active participants 128

Signature of
Role Plan administrator
Date 2021-06-07
Name of individual signing MERIDETH CREECY
Valid signature Filed with authorized/valid electronic signature
OCEANWAY MEDICAL CENTER INC. 401(K) PROFIT SHARING PLAN AND TRUST 2019 542113873 2020-03-11 FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC 25
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 9047447300
Plan sponsor’s address 6484 FORT CAROLINE ROAD, JACKSONVILLE, FL, 32277
OCEANWAY MEDICAL CENTER INC. 401(K) PROFIT SHARING PLAN AND TRUST 2018 542113873 2019-08-06 FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 9047516200
Plan sponsor’s address 11513 N. MAIN STREET, JACKSONVILLE, FL, 32218
FAMILY CARE PARTNERS OF NORTHEAST FLORIDA WELFARE BENEFITS PLAN 2017 542113873 2019-08-28 FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC 158
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2001-03-01
Business code 621111
Sponsor’s telephone number 9047453618
Plan sponsor’s mailing address 6520 FORT CAROLINE RD, JACKSONVILLE, FL, 322772044
Plan sponsor’s address 6520 FORT CAROLINE RD, JACKSONVILLE, FL, 322772044

Number of participants as of the end of the plan year
Active participants 143
Retired or separated participants receiving benefits 6
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2019-08-28
Name of individual signing MERIDETH CREECY
Valid signature Filed with authorized/valid electronic signature
OCEANWAY MEDICAL CENTER INC. 401(K) PROFIT SHARING PLAN AND TRUST 2017 542113873 2018-09-27 FAMILY CARE PARTNERS OF NORTHEAST FLORIDA LLC 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 9047516200
Plan sponsor’s address 11513 N. MAIN STREET, JACKSONVILLE, FL, 32218
OCEANWAY MEDICAL CENTER INC. 401(K) PROFIT SHARING PLAN AND TRUST 2016 542113873 2017-10-11 FAMILY CARE PARTNERS OF NORTHEAST FLORIDA LLC 31
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 9047516200
Plan sponsor’s address 11513 N. MAIN STREET, JACKSONVILLE, FL, 32218
OCEANWAY MEDICAL CENTER INC. 401(K) PROFIT SHARING PLAN AND TRUST 2015 542113873 2016-10-04 FAMILY CARE PARTNERS OF NORTHEAST FLORIDA LLC 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 9047516200
Plan sponsor’s address 11513 N. MAIN STREET, JACKSONVILLE, FL, 32218

Agent

Name Role Address
CT CORPORATION SYSTEM Agent 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324

Vice President

Name Role Address
Malton, Douglas Vice President 425 W. Colonial Dr, Ste 303 Orlando, FL 32804

Chief Financial Officer

Name Role Address
Malton, Douglas Chief Financial Officer 425 W. Colonial Dr, Ste 303 Orlando, FL 32804

Member

Name Role
FAMILY CARE PARTNERS HOLDINGS, LLC Member

Secretary

Name Role Address
Brown, David Secretary 425 W. Colonial Dr, Ste 303 Orlando, FL 32804

President

Name Role Address
Abbott, Will President 425 W. Colonial Dr, Ste 303 Orlando, FL 32804

Chief Executive Officer

Name Role Address
Abbott, Will Chief Executive Officer 425 W. Colonial Dr, Ste 303 Orlando, FL 32804

Chief Operating Officer

Name Role Address
Moyer, Amy Chief Operating Officer 425 W. Colonial Dr, Ste 303 Orlando, FL 32804

Chief Marketing Officer

Name Role Address
Nigam, Rupesh Chief Marketing Officer 425 W. Colonial Dr, Ste 303 Orlando, FL 32804

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000132857 INNOVACARE HEALTH ACTIVE 2024-10-30 2029-12-31 No data 425 W. COLONIAL DR., STE 303, ORLANDO, FL, 32804
G22000071483 ERGENT CARE ACTIVE 2022-06-13 2027-12-31 No data 1215 DUNN AVE #1, JACKSONVILLE, FL, 32218
G21000117723 PARK MEDICAL CENTER ACTIVE 2021-09-14 2026-12-31 No data 847 PARK AVE, ORANGE PARK, FL, 32073
G15000126586 FIRST COAST NEPHROLOGY EXPIRED 2015-12-15 2020-12-31 No data 2732 TROLLIE LANE, JACKSONVILLE, FL, 32211
G12000095962 ERGENT CARE EXPIRED 2012-10-01 2017-12-31 No data 6520 FORT CAROLINE ROAD, JACKSONVILLE, FL, 32277
G08042900189 FAMILY CARE PARTNERS OF ARGYLE EXPIRED 2008-02-08 2013-12-31 No data 8563-2 ARGYLE BUSINESS LOOP, JACKSONVILLE, FL, 32244

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-10-29 425 W. Colonial Dr, Ste 303, Orlando, FL 32804 No data
CHANGE OF MAILING ADDRESS 2024-10-29 425 W. Colonial Dr, Ste 303, Orlando, FL 32804 No data
LC STMNT OF RA/RO CHG 2021-05-17 No data No data
REGISTERED AGENT NAME CHANGED 2021-05-17 CT CORPORATION SYSTEM No data
REGISTERED AGENT ADDRESS CHANGED 2021-05-17 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 No data
LC AMENDMENT 2017-10-17 No data No data

Documents

Name Date
ANNUAL REPORT 2025-01-03
AMENDED ANNUAL REPORT 2024-10-29
ANNUAL REPORT 2024-04-25
AMENDED ANNUAL REPORT 2023-12-06
ANNUAL REPORT 2023-02-24
ANNUAL REPORT 2022-03-29
AMENDED ANNUAL REPORT 2021-08-05
AMENDED ANNUAL REPORT 2021-08-03
CORLCRACHG 2021-05-17
ANNUAL REPORT 2021-03-24

Related by officers

Malton, Douglas

VILLAGE PHYSICIAN GROUP, LLC CURRY FORD PHYSICIAN GROUP, LLC ST. CLOUD PHYSICIAN GROUP, LLC DEBARY PHYSICIAN GROUP, LLC WEST COLONIAL PHYSICIAN GROUP, LLC CONWAY PHYSICIAN GROUP, LLC ALAFAYA PHYSICIAN GROUP, LLC FAMILY CARE PARTNERS URGENT CARE, LLC JOHN YOUNG PHYSICIAN GROUP, LLC ACCESS CENTRAL FLORIDA, INC

Brown, David

SIDE PROJECT, INC. BREAKING 80 MOVIE, LLC SKIN CARE SEARCH.COM, INC. CARE PARTNERS CLINICAL RESEARCH, LLC CUSTOM DECORATORS, INC. FLORIDA ABLE, INC. FAMILY SUCCESS SERVICES, INCORPORATED ACCOUNTABLE CARE OF NORTHEAST FLORIDA, LLC VILLAGE PHYSICIAN GROUP, LLC CURRY FORD PHYSICIAN GROUP, LLC

Abbott, Will

WEST COLONIAL PHYSICIAN GROUP, LLC FAMILY CARE PARTNERS URGENT CARE, LLC JOHN YOUNG PHYSICIAN GROUP, LLC INNOVACARE CENTRAL FLORIDA PHYSICIANS, LLC FAMILY FIRST MEDICAL PHYSICIANS, LLC GOLDENROD PHYSICIAN GROUP, LLC

Moyer, Amy

STAN JOHNSON SERVICES, INC. FAMILY CARE PARTNERS URGENT CARE, LLC JOHN YOUNG PHYSICIAN GROUP, LLC GOLDENROD PHYSICIAN GROUP, LLC

Nigam, Rupesh

FAMILY CARE PARTNERS URGENT CARE, LLC JOHN YOUNG PHYSICIAN GROUP, LLC GOLDENROD PHYSICIAN GROUP, LLC

CT CORPORATION SYSTEM

TMB PANAMA, LLC NAPLES FLORIDA II, LIMITED PARTNERSHIP EXTRA SPACE OF COCONUT POINT LLC MORAN SHIPPING AGENCIES INC. CS KEY WEST I, LLC. MARINA MANAGER, INC. DALLAS NATIONAL INSURANCE COMPANY MAYARAINBOW II, LLC PRESTON STABLES, LLC NW FLORIDA EMERGENCY PHYSICIANS, LLC

Related by address

425 W. Colonial Dr, Ste 303, Orlando, FL 32804

CARE PARTNERS CLINICAL RESEARCH, LLC ACCOUNTABLE CARE OF NORTHEAST FLORIDA, LLC CURRY FORD PHYSICIAN GROUP, LLC ALTAMONTE SPRINGS PHYSICIAN GROUP 2, LLC ST. CLOUD PHYSICIAN GROUP, LLC DEBARY PHYSICIAN GROUP, LLC CONWAY PHYSICIAN GROUP, LLC ALAFAYA PHYSICIAN GROUP, LLC FAMILY CARE PARTNERS URGENT CARE, LLC JOHN YOUNG PHYSICIAN GROUP, LLC

425 W. Colonial Dr, Ste 303, Orlando, FL 32804

CARE PARTNERS CLINICAL RESEARCH, LLC ACCOUNTABLE CARE OF NORTHEAST FLORIDA, LLC CURRY FORD PHYSICIAN GROUP, LLC ALTAMONTE SPRINGS PHYSICIAN GROUP 2, LLC ST. CLOUD PHYSICIAN GROUP, LLC DEBARY PHYSICIAN GROUP, LLC CONWAY PHYSICIAN GROUP, LLC ALAFAYA PHYSICIAN GROUP, LLC FAMILY CARE PARTNERS URGENT CARE, LLC JOHN YOUNG PHYSICIAN GROUP, LLC

Date of last update: 06 Jan 2025

Sources: Florida Department of State

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