| Entity Name: | CRESCENT BEACH CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 Mar 2013 (12 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 31 Oct 2019 (5 years ago) |
| Document Number: | L13000044236 |
| FEI/EIN Number | 46-2354352 |
| Address: | 6573 A1A SOUTH, ST AUGUSTINE, FL, 32080-7504, US |
| Mail Address: | 6573 A1A SOUTH, ST AUGUSTINE, FL, 32080-7504, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033451380 | 2013-03-25 | 2013-05-18 | 6573 A1A S, SAINT AUGUSTINE, FL, 320807504, US | 6573 A1A S, SAINT AUGUSTINE, FL, 320807504, US | |||||||||||||||||||
|
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| Phone | +1 904-342-7363 |
| Fax | 9043427367 |
Authorized person
| Name | DR. ADRIAN SHANE LONG |
| Role | MEMBER-MANAGED |
| Phone | 9043427363 |
Taxonomy
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| License Number | ME109167 |
| State | FL |
| Is Primary | Yes |
| LEI number | Registered As | Jurisdiction Of Formation | General Category | Entity Status | Entity created at | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 549300TKZ3MGHH2XEH49 | L13000044236 | US-FL | GENERAL | ACTIVE | No data | |||||||||||||||||||
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| Legal | C/O ANDREWS, GAIL E, 1750-G A1A SOUTH, ST AUGUSTINE, US-FL, US, 32080 |
| Headquarters | 6573 A1A SOUTH, St Augustine, US-FL, US, 32080 |
Registration details
| Registration Date | 2021-04-30 |
| Last Update | 2023-08-04 |
| Status | LAPSED |
| Next Renewal | 2022-04-29 |
| LEI Issuer | 5493001KJTIIGC8Y1R12 |
| Corroboration Level | FULLY_CORROBORATED |
| Data Validated As | L13000044236 |
| Name | Role | Address |
|---|---|---|
| ANDREWS GAIL E | Agent | 1750-G A1A SOUTH, ST AUGUSTINE, FL, 32080 |
| Name | Role | Address |
|---|---|---|
| LONG ADRIAN S | Managing Member | 6573 A1A SOUTH, ST AUGUSTINE, FL, 320807504 |
| Name | Role | Address |
|---|---|---|
| Thorhallsdottir Margret | Manager | 6573 A1A SOUTH, ST AUGUSTINE, FL, 320807504 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2019-10-31 | ANDREWS, GAIL E | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-10-31 | 1750-G A1A SOUTH, ST AUGUSTINE, FL 32080 | No data |
| LC STMNT OF RA/RO CHG | 2019-10-31 | No data | No data |
| REINSTATEMENT | 2019-10-16 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-12 | 6573 A1A SOUTH, ST AUGUSTINE, FL 32080-7504 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-12 | 6573 A1A SOUTH, ST AUGUSTINE, FL 32080-7504 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-01-16 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-01-14 |
| ANNUAL REPORT | 2020-02-12 |
| CORLCRACHG | 2019-10-31 |
| REINSTATEMENT | 2019-10-16 |
| ANNUAL REPORT | 2018-01-12 |
| ANNUAL REPORT | 2017-01-19 |
| ANNUAL REPORT | 2016-04-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
