| Entity Name: | PORT ORANGE GYNECOLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
PORT ORANGE GYNECOLOGY, 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: | 15 Jan 2010 (15 years ago) |
| Date of dissolution: | 22 Sep 2023 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (2 years ago) |
| Document Number: | L10000005403 |
| FEI/EIN Number |
271697726
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 900 N. SWALLOWTAIL DRIVE, ST 102B, PORT ORANGE, FL, 32129 |
| Mail Address: | 900 N. SWALLOWTAIL DRIVE, ST 102B, PORT ORANGE, FL, 32129 |
| ZIP code: | 32129 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548600869 | 2013-07-01 | 2013-10-09 | PO BOX 12051, BELFAST, ME, 049154011, US | 900 N SWALLOWTAIL DR, ST 102B, PORT ORANGE, FL, 321296102, US | |||||||||||||||||||||||||
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| Phone | +1 386-492-6929 |
| Fax | 3864926930 |
Authorized person
| Name | PAULA M. FOUST |
| Role | M.D. OWNER |
| Phone | 3864926929 |
Taxonomy
| Taxonomy Code | 207VG0400X - Gynecology Physician |
| License Number | ME97528 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 277730400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FOUST PAULA MMD | Managing Member | 400 Rio Grande, Edgewater, FL, 32141 |
| Foust Alexandra | Auth | 4932 Jay St NE, Washington, FL, 20019 |
| FOUST PAULA MMD | Agent | 400 Rio Grande, Edgewater, FL, 32141 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-19 | 400 Rio Grande, Edgewater, FL 32141 | - |
| REINSTATEMENT | 2014-10-02 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | - | - |
| REINSTATEMENT | 2013-02-21 | - | - |
| PENDING REINSTATEMENT | 2013-02-21 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2013-02-21 | 900 N. SWALLOWTAIL DRIVE, ST 102B, PORT ORANGE, FL 32129 | - |
| CHANGE OF MAILING ADDRESS | 2013-02-21 | 900 N. SWALLOWTAIL DRIVE, ST 102B, PORT ORANGE, FL 32129 | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-03-18 |
| ANNUAL REPORT | 2020-06-03 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-04-14 |
| ANNUAL REPORT | 2015-03-18 |
| REINSTATEMENT | 2014-10-02 |
| REINSTATEMENT | 2013-02-21 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5463777208 | 2020-04-27 | 0491 | PPP | 900 N SWALLOWTAIL DR ST B-102, PORT ORANGE, FL, 32129 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Apr 2025
Sources: Florida Department of State
