| Entity Name: | COASTAL REHAB AND SPORTS MEDICINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Jan 2013 (12 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 03 Oct 2017 (7 years ago) |
| Document Number: | L13000003450 |
| FEI/EIN Number | 46-1705597 |
| Address: | 360 Palm Coast Parkway NE, PALM COAST, FL, 32137, US |
| Mail Address: | 360 Palm Coast Parkway NE, PALM COAST, FL, 32137, US |
| ZIP code: | 32137 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982946810 | 2013-03-18 | 2022-06-09 | 360 PALM COAST PKWY NE, PALM COAST, FL, 321373805, US | 360 PALM COAST PKWY NE, PALM COAST, FL, 321373805, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 386-446-4101 |
| Fax | 3864472161 |
Authorized person
| Name | WILLIAM JOSEPH SIBILLE |
| Role | OWNER |
| Phone | 9045014344 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| License Number | PT21524 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SIBILLE WILLIAM J | Agent | 160 Costa Blanca Rd, ST AUGUSTINE, FL, 32095 |
| Name | Role | Address |
|---|---|---|
| SIBILLE WILLIAM J | Managing Member | 160 Costa Blanca Rd, ST AUGUSTINE, FL, 32095 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-07 | 360 Palm Coast Parkway NE, PALM COAST, FL 32137 | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-07 | 360 Palm Coast Parkway NE, PALM COAST, FL 32137 | No data |
| REINSTATEMENT | 2017-10-03 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-10-03 | SIBILLE, WILLIAM J | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-10-03 | 160 Costa Blanca Rd, ST AUGUSTINE, FL 32095 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-02 |
| ANNUAL REPORT | 2024-01-28 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-01-07 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-04-06 |
| REINSTATEMENT | 2017-10-03 |
| ANNUAL REPORT | 2016-04-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
