| Entity Name: | HOLY TRINITY COMMUNITY MEDICAL CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 11 Jul 2011 (14 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | L11000079144 |
| FEI/EIN Number | 452730301 |
| Address: | 100 ARRICOLA AVENUE, ST. AUGUSTINE, FL, 32080 |
| Mail Address: | 100 ARRICOLA AVENUE, ST. AUGUSTINE, FL, 32080 |
| ZIP code: | 32080 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831454248 | 2012-07-11 | 2018-09-17 | 4001 CONFEDERATE POINT RD, SUITE # 2, JACKSONVILLE, FL, 322105459, US | 4001 CONFEDERATE POINT RD, SUITE # 2, JACKSONVILLE, FL, 322105459, US | |||||||||||||||||||||
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| Phone | +1 904-908-0046 |
| Fax | 9049080329 |
Authorized person
| Name | DR. SHARON LISA ACEVEDO |
| Role | PHYSICIAN |
| Phone | 9049080046 |
Taxonomy
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 277361600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CULVER DAVID A | Agent | 100 ARRICOLA AVENUE, ST. AUGUSTINE, FL, 32080 |
| Name | Role | Address |
|---|---|---|
| HINMAN ROY HII | Manager | 100 ARRICOLA AVENUE, ST. AUGUSTINE, FL, 32080 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| LC AMENDMENT | 2020-02-18 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-02-18 | 100 ARRICOLA AVENUE, ST. AUGUSTINE, FL 32080 | No data |
| CHANGE OF MAILING ADDRESS | 2020-02-18 | 100 ARRICOLA AVENUE, ST. AUGUSTINE, FL 32080 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-02-18 | CULVER, DAVID A | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-02-18 | 100 ARRICOLA AVENUE, ST. AUGUSTINE, FL 32080 | No data |
| Name | Date |
|---|---|
| LC Amendment | 2020-02-18 |
| ANNUAL REPORT | 2019-09-11 |
| ANNUAL REPORT | 2018-03-07 |
| ANNUAL REPORT | 2017-07-01 |
| ANNUAL REPORT | 2016-03-06 |
| ANNUAL REPORT | 2015-04-21 |
| ANNUAL REPORT | 2014-04-29 |
| ANNUAL REPORT | 2013-04-15 |
| ANNUAL REPORT | 2012-05-06 |
| Florida Limited Liability | 2011-07-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
