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FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC - Florida Company Profile

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Company Details

Entity Name: FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
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, US
Mail Address: 425 W. Colonial Dr, Ste 303, Orlando, FL, 32804, US
ZIP code: 32804
City: Orlando
County: Orange
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
- Member -
CT CORPORATION SYSTEM Agent 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324
Malton Douglas Vice President 425 W. Colonial Dr, Orlando, FL, 32804
Brown David Secretary 425 W. Colonial Dr, Orlando, FL, 32804
Abbott Will President 425 W. Colonial Dr, Orlando, FL, 32804
Moyer Amy Chief Operating Officer 425 W. Colonial Dr, Orlando, FL, 32804
Nigam Rupesh Chief Marketing Officer 425 W. Colonial Dr, Orlando, FL, 32804

Unique Entity ID

CAGE Code:
6YXJ4
UEI Expiration Date:
2016-09-20

Business Information

Division Name:
FAMILY CARE PARTNERS OF NORTHEAST FLORIDA
Activation Date:
2015-09-21
Initial Registration Date:
2013-08-12

Commercial and government entity program

CAGE number:
6YXJ4
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2022-02-21
CAGE Expiration:
2022-02-20

Contact Information

POC:
ANDREW STANSFIELD
Corporate URL:
www.familycarepartners.com

National Provider Identifier

NPI Number:
1417559147
Certification Date:
2025-01-03

Authorized Person:

Name:
DAVID BROWN
Role:
SECRETARY
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
9047224271
Fax:
9046967462

Form 5500 Series

Employer Identification Number (EIN):
542113873
Plan Year:
2020
Number Of Participants:
128
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
367
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
128
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
25
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
29
Sponsors Telephone Number:

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 - 425 W. COLONIAL DR., STE 303, ORLANDO, FL, 32804
G22000071483 ERGENT CARE ACTIVE 2022-06-13 2027-12-31 - 1215 DUNN AVE #1, JACKSONVILLE, FL, 32218
G21000117723 PARK MEDICAL CENTER ACTIVE 2021-09-14 2026-12-31 - 847 PARK AVE, ORANGE PARK, FL, 32073
G15000126586 FIRST COAST NEPHROLOGY EXPIRED 2015-12-15 2020-12-31 - 2732 TROLLIE LANE, JACKSONVILLE, FL, 32211
G12000095962 ERGENT CARE EXPIRED 2012-10-01 2017-12-31 - 6520 FORT CAROLINE ROAD, JACKSONVILLE, FL, 32277
G08042900189 FAMILY CARE PARTNERS OF ARGYLE EXPIRED 2008-02-08 2013-12-31 - 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 -
CHANGE OF MAILING ADDRESS 2024-10-29 425 W. Colonial Dr, Ste 303, Orlando, FL 32804 -
LC STMNT OF RA/RO CHG 2021-05-17 - -
REGISTERED AGENT NAME CHANGED 2021-05-17 CT CORPORATION SYSTEM -
REGISTERED AGENT ADDRESS CHANGED 2021-05-17 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 -
LC AMENDMENT 2017-10-17 - -

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

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Date of last update: 01 Jul 2025

Sources: Florida Department of State