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  5. AMELIA URGENT CARE, LLC

AMELIA URGENT CARE, LLC

Company Details

Entity Name: AMELIA URGENT CARE, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 22 Jun 2005 (20 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 15 Oct 2014 (10 years ago)
Document Number: L05000062366
FEI/EIN Number 203333281
Address: 96279 BRADY PT RD, FERNANDINA BEACH, FL, 32034
Mail Address: 96279 BRADY PT RD, FERNANDINA BEACH, FL, 32034
ZIP code: 32034
County: Nassau
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1720417884 2013-11-08 2013-11-08 510 AIRPORT CENTER DR, JACKSONVILLE, FL, 322187260, US 96279 BRADY POINT RD, FERNANDINA BEACH, FL, 320347076, US

Contacts
Phone +1 904-696-0055
Fax 9045516533
Phone +1 904-321-1177
Fax 9043210016

Authorized person
Name DR. DANIEL MATRICIA
Role MEDICAL DIRECTOR/OWNER
Phone 9045833016

Taxonomy
Taxonomy Code 261QC0050X - Critical Access Hospital Clinic/Center
License Number OS6933
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AMELIA URGENT CARE 401(K) PLAN 2016 203333281 2017-07-27 AMELIA URGENT CARE 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621340
Sponsor’s telephone number 9043210088
Plan sponsor’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034
AMELIA URGENT CARE 401(K) PLAN 2015 203333281 2016-10-11 AMELIA URGENT CARE 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621340
Sponsor’s telephone number 9043210088
Plan sponsor’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034
AMELIA URGENT CARE 401(K) PLAN 2014 203333281 2015-10-15 AMELIA URGENT CARE 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621340
Sponsor’s telephone number 9043210088
Plan sponsor’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing SUE MATRICIA
Valid signature Filed with authorized/valid electronic signature
AMELIA URGENT CARE 401(K) PLAN 2013 203333281 2014-10-15 AMELIA URGENT CARE 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621340
Sponsor’s telephone number 9043210088
Plan sponsor’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2014-10-15
Name of individual signing DANIEL J. MATRICIA, M.D.
Valid signature Filed with authorized/valid electronic signature
AMELIA URGENT CARE 401(K) PLAN 2012 203333281 2013-10-08 AMELIA URGENT CARE 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621340
Sponsor’s telephone number 9043210088
Plan sponsor’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2013-10-08
Name of individual signing DANIEL J. MATRICIA, M.D.
Valid signature Filed with authorized/valid electronic signature
AMELIA URGENT CARE 401(K) PLAN 2011 203333281 2012-10-03 AMELIA URGENT CARE 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621340
Sponsor’s telephone number 9043210088
Plan sponsor’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034

Plan administrator’s name and address
Administrator’s EIN 203333281
Plan administrator’s name AMELIA URGENT CARE
Plan administrator’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034
Administrator’s telephone number 9043210088

Signature of
Role Plan administrator
Date 2012-10-03
Name of individual signing DANIEL J. MATRICIA, D.O.
Valid signature Filed with authorized/valid electronic signature
AMELIA URGENT CARE 401(K) PLAN 2010 203333281 2011-11-10 AMELIA URGENT CARE 9
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621340
Sponsor’s telephone number 9043210088
Plan sponsor’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034

Plan administrator’s name and address
Administrator’s EIN 203333281
Plan administrator’s name AMELIA URGENT CARE
Plan administrator’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034
Administrator’s telephone number 9043210088

Signature of
Role Plan administrator
Date 2011-11-10
Name of individual signing DANIEL J. MATRICIA, M.D.
Valid signature Filed with incorrect/unrecognized electronic signature
AMELIA URGENT CARE 401(K) PLAN 2010 203333281 2012-05-03 AMELIA URGENT CARE 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621340
Sponsor’s telephone number 9043210088
Plan sponsor’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034

Plan administrator’s name and address
Administrator’s EIN 203333281
Plan administrator’s name AMELIA URGENT CARE
Plan administrator’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034
Administrator’s telephone number 9043210088

Signature of
Role Plan administrator
Date 2012-05-03
Name of individual signing CHARLES A. BROWN
Valid signature Filed with authorized/valid electronic signature
AMELIA URGENT CARE 401(K) PLAN 2010 203333281 2011-11-29 AMELIA URGENT CARE 9
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621340
Sponsor’s telephone number 9043210088
Plan sponsor’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034

Plan administrator’s name and address
Administrator’s EIN 203333281
Plan administrator’s name AMELIA URGENT CARE
Plan administrator’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034
Administrator’s telephone number 9043210088

Signature of
Role Plan administrator
Date 2011-11-29
Name of individual signing DANIEL J. MATRICIA, M.D.
Valid signature Filed with incorrect/unrecognized electronic signature
AMELIA URGENT CARE 401(K) PLAN 2009 203333281 2010-10-13 AMELIA URGENT CARE 10
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621340
Sponsor’s telephone number 9043210088
Plan sponsor’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034

Plan administrator’s name and address
Administrator’s EIN 203333281
Plan administrator’s name AMELIA URGENT CARE
Plan administrator’s address 96279 BRADY POINT ROAD, FERNANDINA BEACH, FL, 32034
Administrator’s telephone number 9043210088

Signature of
Role Plan administrator
Date 2010-10-12
Name of individual signing DANIEL J. MATRICIA, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-12
Name of individual signing DANIEL J. MATRICIA, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MATRICIA SUE M Agent 1768 REGATTA DR, FERNANDINA BEACH, FL, 32034

Manager

Name Role Address
MATRICIA DANIEL J Manager 1768 REGATTA DRIVE, FERNANDINA BEACH, FL, 320345534
MATRICIA SUE M Manager 1768 REGATTA DRIVE, FERNANDINA BEACH, FL, 320345534

Events

Event Type Filed Date Value Description
REINSTATEMENT 2014-10-15 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2014-09-26 No data No data
CHANGE OF PRINCIPAL ADDRESS 2011-04-26 96279 BRADY PT RD, FERNANDINA BEACH, FL 32034 No data
CHANGE OF MAILING ADDRESS 2011-04-26 96279 BRADY PT RD, FERNANDINA BEACH, FL 32034 No data
REGISTERED AGENT ADDRESS CHANGED 2007-04-30 1768 REGATTA DR, FERNANDINA BEACH, FL 32034 No data
REGISTERED AGENT NAME CHANGED 2007-04-30 MATRICIA, SUE M No data
AMENDMENT 2005-09-13 No data No data

Documents

Name Date
ANNUAL REPORT 2024-04-26
ANNUAL REPORT 2023-04-30
ANNUAL REPORT 2022-04-18
ANNUAL REPORT 2021-05-05
ANNUAL REPORT 2020-04-06
ANNUAL REPORT 2019-04-29
ANNUAL REPORT 2018-02-14
ANNUAL REPORT 2017-01-12
ANNUAL REPORT 2016-09-07
ANNUAL REPORT 2015-07-24

Related by officers

MATRICIA DANIEL J

AMELIA MEDICAL PARK CONDOMINIUM ASSOCIATION, INC. DANIEL J. MATRICIA, LLC AMELIA MED, LLC FIRST COAST EMERGENCY SERVICES, P.A.

MATRICIA SUE M

DANIEL J. MATRICIA, LLC AMELIA MED, LLC FIRST COAST EMERGENCY SERVICES, P.A.

Related by address

96279 BRADY PT RD, FERNANDINA BEACH, FL, 32034

AMELIA MED, LLC

96279 BRADY PT RD, FERNANDINA BEACH, FL, 32034

AMELIA MED, LLC

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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