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FAMILY MEDICAL CARE OF PALM COAST, LLC - Florida Company Profile

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Company Details

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.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

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
City: Palm Coast
County: Flagler
Place of Formation: FLORIDA

Key Officers & Management

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

National Provider Identifier

NPI Number:
1912177577

Authorized Person:

Name:
DR. ANTONIO SISON VICENCIO III
Role:
SOLE PROPRIETOR
Phone:

Taxonomy:

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

Contacts:

Fax:
3865863467

Form 5500 Series

Employer Identification Number (EIN):
260607201
Plan Year:
2022
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
9
Sponsors Telephone Number:

Events

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 -

Documents

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

Paycheck Protection Program

Jobs Reported:
12
Initial Approval Amount:
$123,977
Date Approved:
2020-05-07
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$123,977
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$125,121.66
Servicing Lender:
Wells Fargo Bank, National Association
Use of Proceeds:
Payroll: $123,977
Jobs Reported:
12
Initial Approval Amount:
$105,080
Date Approved:
2021-01-22
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$105,080
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$106,024.28
Servicing Lender:
Wells Fargo Bank, National Association
Use of Proceeds:
Payroll: $105,078
Utilities: $1

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Date of last update: 03 Jul 2025

Sources: Florida Department of State