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COASTAL FOOT & ANKLE WELLNESS CENTER, LLC - Florida Company Profile

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Company Details

Entity Name: COASTAL FOOT & ANKLE WELLNESS CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 12 Jan 2010 (16 years ago)
Document Number: L10000004472
FEI/EIN Number 27-1667467
Address: 1740 Tree Blvd Suite 112, ST. AUGUSTINE, FL, 32084, US
Mail Address: 1740 Tree Blvd Suite 112, ST. AUGUSTINE, FL, 32084, US
ZIP code: 32084
City: Saint Augustine
County: St. Johns
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
JOHNSON RICHARD WDPM Managing Member 1740 Tree Blvd Suite 112, ST. AUGUSTINE, FL, 32084
CONCHA JOSE MDPM Managing Member 1740 Tree Blvd Suite 112, ST. AUGUSTINE, FL, 32084
Johnson Richard Agent 1740 Tree Blvd Suite 112, ST. AUGUSTINE, FL, 32084

National Provider Identifier

NPI Number:
1972834760
Certification Date:
2020-12-27

Authorized Person:

Name:
DR. RICHARD W JOHNSON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
213ES0103X - Foot & Ankle Surgery Podiatrist
Is Primary:
Yes

Contacts:

Fax:
9048261920

Form 5500 Series

Employer Identification Number (EIN):
271667467
Plan Year:
2023
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
7
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2021-01-18 1740 Tree Blvd Suite 112, ST. AUGUSTINE, FL 32084 -
CHANGE OF MAILING ADDRESS 2021-01-18 1740 Tree Blvd Suite 112, ST. AUGUSTINE, FL 32084 -
REGISTERED AGENT NAME CHANGED 2021-01-18 Johnson, Richard -
REGISTERED AGENT ADDRESS CHANGED 2021-01-18 1740 Tree Blvd Suite 112, ST. AUGUSTINE, FL 32084 -

Documents

Name Date
ANNUAL REPORT 2025-01-14
ANNUAL REPORT 2024-01-18
ANNUAL REPORT 2023-04-25
ANNUAL REPORT 2022-01-07
ANNUAL REPORT 2021-01-18
ANNUAL REPORT 2020-01-06
ANNUAL REPORT 2019-02-05
ANNUAL REPORT 2018-02-02
AMENDED ANNUAL REPORT 2017-04-18
ANNUAL REPORT 2017-01-16

USAspending Awards / Financial Assistance

Date:
2020-06-12
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO PROVIDE LOANS TO RESTORE AS NEARLY AS POSSIBLE THE VICTIMS OF ECONOMIC INJURY TYPE DISASTERS TO PRE-DISASTER CONDITIONS
Obligated Amount:
0.00
Face Value Of Loan:
150000.00
Total Face Value Of Loan:
150000.00
Date:
2020-04-28
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:
103800.00
Total Face Value Of Loan:
103800.00
Date:
2020-04-28
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:
103800.00
Total Face Value Of Loan:
103800.00

Paycheck Protection Program

Jobs Reported:
8
Initial Approval Amount:
$103,800
Date Approved:
2020-04-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$103,800
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$104,877.81
Servicing Lender:
Ameris Bank
Use of Proceeds:
Payroll: $83,040
Utilities: $20,760

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Date of last update: 01 Aug 2025

Sources: Florida Department of State