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FAMILY HEALTH CENTER AT PORT ST JOHN LLC - Florida Company Profile

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Company Details

Entity Name: FAMILY HEALTH CENTER AT PORT ST JOHN LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 05 Nov 2007 (18 years ago)
Document Number: L07000111602
FEI/EIN Number 261350798
Address: 3740 CURTIS BLVD, SUITE 108, COCOA, FL, 32927
Mail Address: 3740 CURTIS BLVD, SUITE 108, COCOA, FL, 32927
ZIP code: 32927
City: Cocoa
County: Brevard
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
BLACK JANIS G Managing Member 5126 ROYAL PADDOCK WAY, MERRITT ISLAND, FL, 32953
BLACK JOHN T Managing Member 5126 ROYAL PADDOCK WAY, MERRITT ISLAND, FL, 32953
BLACK JANIS G Agent 5126 ROYAL PADDOCK WAY, MERRIT ISLAND, FL, 32953

National Provider Identifier

NPI Number:
1851575377

Authorized Person:

Name:
DR. JANIS G BLACK
Role:
PHYSICIAN/OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
3216335566

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G11000067986 FAMILY HEALTH CENTER AT CHICKASAW TRAIL EXPIRED 2011-07-06 2016-12-31 - 540 S CHICKASAW TRAIL, ORLANDO, FL, 32825

Documents

Name Date
ANNUAL REPORT 2024-04-03
ANNUAL REPORT 2023-04-03
ANNUAL REPORT 2022-04-06
ANNUAL REPORT 2021-04-08
ANNUAL REPORT 2020-03-17
ANNUAL REPORT 2019-05-11
ANNUAL REPORT 2018-03-01
ANNUAL REPORT 2017-07-03
ANNUAL REPORT 2016-04-12
ANNUAL REPORT 2015-04-23

USAspending Awards / Financial Assistance

Date:
2020-04-14
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
109900.00
Total Face Value Of Loan:
109900.00
Date:
2020-04-14
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
109900.00
Total Face Value Of Loan:
109900.00

Paycheck Protection Program

Jobs Reported:
12
Initial Approval Amount:
$109,900
Date Approved:
2020-04-14
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$109,900
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$110,824.99
Servicing Lender:
Truist Bank
Use of Proceeds:
Payroll: $109,900

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Date of last update: 01 Aug 2025

Sources: Florida Department of State