| Entity Name: | COASTAL SKILLED CARE PROVIDERS , LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 Feb 2014 (11 years ago) |
| Document Number: | L14000024651 |
| FEI/EIN Number | 46-4827067 |
| Address: | 767 TIMOTHY STREET, ORMOND BEACH, FL 32174 |
| Mail Address: | 767 TIMOTHY STREET, ORMOND BEACH, FL 32174 |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508272683 | 2014-07-09 | 2014-07-09 | 767 TIMOTHY ST, ORMOND BEACH, FL, 321742909, US | 767 TIMOTHY ST, ORMOND BEACH, FL, 321742909, US | |||||||||||||||||
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| Phone | +1 407-496-9399 |
Authorized person
| Name | DR. LOTHAR MICHAEL GEBAUER |
| Role | OFFICER |
| Phone | 4074969399 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME98984 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GEBAUER, LOTHAR M | Agent | 767 TIMOTHY STREET, ORMOND BEACH, FL 32174 |
| Name | Role | Address |
|---|---|---|
| GEBAUER, LOTHAR M | Authorized Member | 767 TIMOTHY STREET, ORMOND BEACH, FL 32174 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-26 |
| ANNUAL REPORT | 2018-02-28 |
| ANNUAL REPORT | 2017-02-15 |
| ANNUAL REPORT | 2016-02-02 |
| ANNUAL REPORT | 2015-02-24 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6446287707 | 2020-05-01 | 0491 | PPP | 767 TIMOTHY ST, ORMOND BEACH, FL, 32174-2909 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6654978507 | 2021-03-04 | 0491 | PPS | 767 Timothy St, Ormond Beach, FL, 32174-2909 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 21 Feb 2025
Sources: Florida Department of State
