| Entity Name: | FAMILY MEDICAL CARE OF PALM COAST, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
FAMILY MEDICAL CARE OF PALM COAST, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 18 Oct 2007 (18 years ago) |
| Date of dissolution: | 13 Mar 2023 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 13 Mar 2023 (2 years ago) |
| Document Number: | L07000106009 |
| FEI/EIN Number |
260607201
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 21 HOSPITAL DRIVE, SUITE 230, PALM COAST, FL, 32164, US |
| Mail Address: | PO BOX 354339, PALM COAST, FL, 32135, US |
| ZIP code: | 32164 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912177577 | 2008-03-10 | 2008-09-10 | PO BOX 354339, PALM COAST, FL, 321354339, US | 21 HOSPITAL DR, SUITE 230, PALM COAST, FL, 321642452, US | |||||||||||||||
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| Phone | +1 386-586-3466 |
| Fax | 3865863467 |
Authorized person
| Name | DR. ANTONIO SISON VICENCIO III |
| Role | SOLE PROPRIETOR |
| Phone | 3865863466 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FAMILY MEDICAL CARE OF PALM COAST, LLC 401(K) PLAN | 2022 | 260607201 | 2023-07-18 | FAMILY MEDICAL CARE OF PALM COAST, LLC | 14 | |||||||||||||
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| FAMILY MEDICAL CARE OF PALM COAST, LLC 401(K) PLAN | 2021 | 260607201 | 2022-05-25 | FAMILY MEDICAL CARE OF PALM COAST, LLC | 11 | |||||||||||||
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| FAMILY MEDICAL CARE OF PALM COAST, LLC 401(K) PLAN | 2020 | 260607201 | 2021-05-24 | FAMILY MEDICAL CARE OF PALM COAST, LLC | 11 | |||||||||||||
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| FAMILY MEDICAL CARE OF PALM COAST, LLC 401(K) PLAN | 2019 | 260607201 | 2020-02-05 | FAMILY MEDICAL CARE OF PALM COAST, LLC | 9 | |||||||||||||
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| FAMILY MEDICAL CARE OF PALM COAST, LLC 401(K) PLAN | 2018 | 260607201 | 2019-03-27 | FAMILY MEDICAL CARE OF PALM COAST, LLC | 9 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| VICENCIO CECILIA | Manager | 21 HOSPITAL DRIVE SUITE 230, PALM COAST, FL, 32164 |
| VICENCIO JONATHAN | Manager | 21 HOSPITAL DRIVE SUITE 230, PALM COAST, FL, 32164 |
| ANTONIO VICENCIO | Managing Member | 21 HOSPITAL DRIVE SUITE 230, PALM COAST, FL, 32164 |
| VICENCIO ANTONIO I | Agent | 21 HOSPITAL DRIVE SUITE 230, PALM COAST, FL, 32137 |
| VICENCIO KRISTOPHER | Manager | 21 HOSPITAL DRIVE SUITE 230, PALM COAST, FL, 32164 |
| VICENCIO JACQUELINE | Manager | 21 HOSPITAL DRIVE SUITE 230, PALM COAST, FL, 32164 |
| VICENCIO KENNETH | Manager | 21 HOSPITAL DRIVE SUITE 230, PALM COAST, FL, 32164 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-03-13 | - | - |
| LC AMENDMENT | 2011-01-27 | - | - |
| LC AMENDMENT | 2010-08-09 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2010-03-25 | 21 HOSPITAL DRIVE, SUITE 230, PALM COAST, FL 32164 | - |
| CHANGE OF MAILING ADDRESS | 2008-04-29 | 21 HOSPITAL DRIVE, SUITE 230, PALM COAST, FL 32164 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2008-04-29 | 21 HOSPITAL DRIVE SUITE 230, PALM COAST, FL 32137 | - |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-03-13 |
| ANNUAL REPORT | 2022-02-28 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-06-27 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-10 |
| ANNUAL REPORT | 2017-02-11 |
| ANNUAL REPORT | 2016-04-14 |
| ANNUAL REPORT | 2015-04-30 |
| ANNUAL REPORT | 2014-02-25 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3470467404 | 2020-05-07 | 0491 | PPP | 21 HOSPITAL DR SUITE 230, PALM COAST, FL, 32164 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3555158302 | 2021-01-22 | 0491 | PPS | 21 Hospital Dr Ste 230, Palm Coast, FL, 32164-2458 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
