| Entity Name: | PELICAN COAST EMERGENCY PHYSICIANS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 17 Oct 2013 (11 years ago) |
| Date of dissolution: | 03 Jun 2024 (8 months ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 03 Jun 2024 (8 months ago) |
| Document Number: | L13000147048 |
| FEI/EIN Number | 20-5641765 |
| Address: | 20 Burton Hills Blvd., Suite 500, NASHVILLE, TN, 37215, US |
| Mail Address: | 20 Burton Hills Blvd., Suite 500, NASHVILLE, TN, 37215, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306926241 | 2006-10-16 | 2013-12-24 | 13737 NOEL RD, STE 1600, DALLAS, TX, 752401331, US | 13695 US HIGHWAY 1, SEBASTIAN, FL, 329583230, US | |||||||||||||||||||||||||||
|
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| Phone | +1 469-401-2386 |
| Phone | +1 772-581-2044 |
Authorized person
| Name | DR. GREGORY BYRNE |
| Role | PRESIDENT |
| Phone | 4694012386 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE SHIELD |
| Number | 98218 |
| State | FL |
| Issuer | MEDICAID |
| Number | 277281700 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| Byrne, M.D. Gregory J | Manager | 20 Burton Hills Blvd., NASHVILLE, TN, 37215 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-06-03 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-18 | 20 Burton Hills Blvd., Suite 500, NASHVILLE, TN 37215 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-18 | 20 Burton Hills Blvd., Suite 500, NASHVILLE, TN 37215 | No data |
| REINSTATEMENT | 2019-02-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-02-28 | CORPORATION SERVICE COMPANY | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CONVERSION | 2013-10-17 | No data | GEN-COR CONVERSION RESULT. THE CONVERTING ENTITY WAS GP1300001433 ORIGINALLY FILED ON 10/16/2013. CONVERSION NUMBER 900000135089 |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-06-03 |
| ANNUAL REPORT | 2024-04-18 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-05-01 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-28 |
| REINSTATEMENT | 2019-02-28 |
| ANNUAL REPORT | 2014-07-16 |
| Florida Limited Liability | 2013-10-17 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
