| Entity Name: | FIRST COAST INFECTIOUS DISEASE CONSULTANTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 May 2007 (18 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 07 Oct 2013 (11 years ago) |
| Document Number: | L07000055370 |
| FEI/EIN Number | 260229265 |
| Address: | 2122 UNIVERSITY BLVD S, JACKSONVILLE, FL, 32216, US |
| Mail Address: | 2122 UNIVERSITY BLVD S, JACKSONVILLE, FL, 32216, US |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740477843 | 2007-10-02 | 2022-10-25 | PO BOX 55009, JACKSONVILLE, FL, 322160009, US | 2122 UNIVERSITY BLVD S, JACKSONVILLE, FL, 322168937, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-398-5614 |
| Fax | 9043985617 |
Authorized person
| Name | SEBASTIAN R STANCIU |
| Role | PRESIDENT |
| Phone | 9043985614 |
Taxonomy
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| License Number | ME89939 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 115420100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SCHWARTZ LAW GROUP, PA | Agent | 10365 HOOD RD. STE 104, JACKSONVILLE, FL, 32257 |
| Name | Role |
|---|---|
| SEBASTIAN STANCIU, M.D.,P.L. | Manager |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-03-05 | 2122 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-03-05 | SCHWARTZ LAW GROUP, PA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-05 | 10365 HOOD RD. STE 104, JACKSONVILLE, FL 32257 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-02-02 | 2122 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216 | No data |
| REINSTATEMENT | 2013-10-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-02 |
| ANNUAL REPORT | 2024-03-05 |
| ANNUAL REPORT | 2023-04-06 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-02-18 |
| ANNUAL REPORT | 2018-01-18 |
| ANNUAL REPORT | 2017-01-16 |
| ANNUAL REPORT | 2016-02-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
