| Entity Name: | COASTAL MIDWIFERY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Oct 2012 (12 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 13 Mar 2016 (9 years ago) |
| Document Number: | L12000131937 |
| FEI/EIN Number | 46-1550179 |
| Address: | 10200 State Road 84, Davie, FL, 33028, US |
| Mail Address: | 10200 State Road 84, Pembroke Pines, FL, 33324, US |
| ZIP code: | 33028 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003223389 | 2014-07-17 | 2014-07-17 | 10200 W STATE ROAD 84, SUITE 230, DAVIE, FL, 333244204, US | 10200 W STATE ROAD 84, SUITE 230, DAVIE, FL, 333244204, US | |||||||||||||||||||||||||
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| Phone | +1 954-648-4990 |
| Fax | 9546448931 |
Authorized person
| Name | CHRISTA WEST |
| Role | OWNER |
| Phone | 9546484990 |
Taxonomy
| Taxonomy Code | 176B00000X - Midwife |
| License Number | MW252 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004436500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WEST CHRISTA M | Agent | 1160 NE 200th Street, Miami, FL, 33179 |
| Name | Role | Address |
|---|---|---|
| WEST CHRISTA M | Manager | 10200 State Road 84, Pembroke Pines, FL, 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-06 | 1160 NE 200th Street, Miami, FL 33179 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-30 | 10200 State Road 84, Suite 207, Davie, FL 33028 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-01-16 | 10200 State Road 84, Suite 207, Davie, FL 33028 | No data |
| REINSTATEMENT | 2016-03-13 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-03-13 | WEST, CHRISTA M | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| LC NAME CHANGE | 2012-11-13 | COASTAL MIDWIFERY, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-06 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-03-09 |
| ANNUAL REPORT | 2020-06-20 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-04-13 |
| REINSTATEMENT | 2016-03-13 |
| ANNUAL REPORT | 2014-01-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
