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COASTAL VASCULAR AND INTERVENTIONAL, P.L.L.C.

COASTAL VASCULAR AND INTERVENTIONAL, P.L.L.C. - Florida Company Profile

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Company Details

Entity Name:	COASTAL VASCULAR AND INTERVENTIONAL, P.L.L.C.
Jurisdiction:	FLORIDA
Filing Type:	Florida Limited Liability Co.
Status:	Active
Date Filed:	07 Aug 2008 (17 years ago)
Last Event:	LC AMENDMENT
Event Date Filed:	19 Aug 2013 (12 years ago)
Document Number:	L08000076105
FEI/EIN Number	263144426
Mail Address:	PO BOX 11982, PENSACOLA, FL, 32524, US
Address:	5149 NORTH NINTH AVENUE, STE. 120, PENSACOLA, FL, 32504, US
ZIP code:	32504
City:	Pensacola
County:	Escambia
Place of Formation:	FLORIDA

Key Officers & Management

Name	Role	Address
BOSARGE CHRISTOPHER JDr.	Managing Member	5149 NORTH NINTH AVENUE, PENSACOLA, FL, 32504
MONTGOMERY AARON BDr.	Managing Member	5149 NORTH NINTH AVENUE, PENSACOLA, FL, 32504
LECROY CHRISTOPHER Dr.	Managing Member	5149 NORTH NINTH AVENUE, PENSACOLA, FL, 32504
Kafie Fernando EDr.	Managing Member	5149 N. 9th Ave., Pensacola, FL, 32504
PATEL SHONAK Dr.	Managing Member	5149 NORTH NINTH AVENUE, Pensacola, FL, 32504
Risley Geoffrey JDr.	Managing Member	5149 NORTH NINTH AVENUE, STE. 120, PENSACOLA, FL, 32504
Rushing Robert	Agent	Carver Darden, PENSACOLA, FL, 32502

Unique Entity ID

CAGE Code:

74WS2

UEI Expiration Date:

2020-10-16

Business Information

Division Name:

COASTAL VASCULAR & INTERVENTIONAL

Activation Date:

2019-10-17

Initial Registration Date:

2014-06-05

National Provider Identifier

NPI Number:

1760055289

Certification Date:

2021-06-24

Link:

View on NPI website

Authorized Person:

Name:

DANELLE FISCHER

Role:

ADMINISTRATOR

Phone:

8504791805

Taxonomy:

Selected Taxonomy:

2085R0202X - Diagnostic Radiology Physician

Is Primary:

No

Selected Taxonomy:

2085R0204X - Vascular & Interventional Radiology Physician

Is Primary:

No

Selected Taxonomy:

2086S0129X - Vascular Surgery Physician

Is Primary:

Yes

Contacts:

Phone:

+1 850-479-1805

Fax:

8504791829

Form 5500 Series

Employer Identification Number (EIN):

263144426

Plan Year:

2024

Number Of Participants:

4

Sponsors Telephone Number:

8504791805

File:

Plan Year:

2024

Number Of Participants:

21

Sponsors Telephone Number:

8504791805

File:

Plan Year:

2023

Number Of Participants:

56

Sponsors Telephone Number:

8504791805

File:

Plan Year:

2022

Number Of Participants:

85

Sponsors Telephone Number:

8504791805

File:

Plan Year:

2021

Number Of Participants:

87

Sponsors Telephone Number:

8504791805

File:

Fictitious Names

Registration Number	Fictitious Name	Status	Filed Date	Expiration Date	Cancellation Date	Mailing Address
G23000028655	COASTAL VEIN INSTITUTE & AESTHETIC CENTER	ACTIVE	2023-03-02	2028-12-31	-	P.O. BOX 11982, PENSACOLA, FL, 32524
G14000037408	COASTAL VEIN INSTITUTE	EXPIRED	2014-04-15	2019-12-31	-	P.O. BOX 11982, PENSACOLA, FL, 32524
G12000079768	COASTAL VEIN INSTITUTE & ANESTHETIC CENTER	EXPIRED	2012-08-13	2017-12-31	-	P.O. BOX 11982, PENSACOLA, FL, 32524
G09000147669	THE COASTAL VEIN CENTER	EXPIRED	2009-08-20	2014-12-31	-	P O BOX 11982, PENSACOLA, FL, 32524
G09000129465	COASTAL VEINS	EXPIRED	2009-06-30	2014-12-31	-	P O BOX 11982, PENSACOLA, FL, 32524

Events

Event Type	Filed Date	Value	Description
REGISTERED AGENT NAME CHANGED	2021-04-29	Rushing, Robert	-
REGISTERED AGENT ADDRESS CHANGED	2021-04-29	Carver Darden, 151 West Main Street, Suite 200, PENSACOLA, FL 32502	-
CHANGE OF PRINCIPAL ADDRESS	2016-02-09	5149 NORTH NINTH AVENUE, STE. 120, PENSACOLA, FL 32504	-
LC AMENDMENT	2013-08-19	-	-
CHANGE OF MAILING ADDRESS	2010-02-08	5149 NORTH NINTH AVENUE, STE. 120, PENSACOLA, FL 32504	-
LC NAME CHANGE	2008-10-27	COASTAL VASCULAR AND INTERVENTIONAL, P.L.L.C.	-
LC ARTICLE OF CORRECTION	2008-09-05	-	-

Documents

Name	Date
ANNUAL REPORT	2025-01-07
ANNUAL REPORT	2024-02-07
ANNUAL REPORT	2023-02-10
ANNUAL REPORT	2022-01-27
AMENDED ANNUAL REPORT	2021-04-29
ANNUAL REPORT	2021-01-18
ANNUAL REPORT	2020-01-17
ANNUAL REPORT	2019-01-24
ANNUAL REPORT	2018-01-15
ANNUAL REPORT	2017-02-07

Paycheck Protection Program

Jobs Reported:

124

Initial Approval Amount:

$1,083,100

Date Approved:

2020-04-13

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$1,083,100

Race:

White

Ethnicity:

Not Hispanic or Latino

Gender:

Male Owned

Veteran:

Unanswered

Forgiveness Amount:

$1,091,141.65

Servicing Lender:

Regions Bank

Use of Proceeds:

Payroll: $1,083,100

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Date of last update: 02 Jul 2025

Sources: Florida Department of State