| Entity Name: | COASTAL PHYSICIAN CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 30 Oct 2014 (10 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | L14000169311 |
| Address: | 90 Cypress Way E, NAPLES, FL, 34110, US |
| Mail Address: | 90 Cypress Way E, NAPLES, FL, 34110, US |
| ZIP code: | 34110 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124424098 | 2014-11-05 | 2014-11-05 | 1865 VETERANS PARK DR STE 202, NAPLES, FL, 341090447, US | 9250 CORKSCREW RD, SUITE 3, ESTERO, FL, 339283208, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 239-898-3836 |
| Phone | +1 239-498-2528 |
Authorized person
| Name | MR. JEREMY L DARSTEK |
| Role | CEO |
| Phone | 2398983836 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207QA0000X - Adolescent Medicine (Family Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207QA0505X - Adult Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207QG0300X - Geriatric Medicine (Family Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207RG0300X - Geriatric Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COASTAL PHYSICIAN CARE, LLC 401(K) PLAN | 2015 | 472211687 | 2016-10-17 | COASTAL PHYSICIAN CARE, LLC | 4 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| DARSTEK JEREMY L | Agent | 90 Cypress Way E, NAPLES, FL, 34110 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| LC DISSOCIATION MEM | 2016-10-31 | No data | No data |
| LC DISSOCIATION MEM | 2016-07-11 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-04-19 | 90 Cypress Way E, Suite 10, NAPLES, FL 34110 | No data |
| CHANGE OF MAILING ADDRESS | 2016-04-19 | 90 Cypress Way E, Suite 10, NAPLES, FL 34110 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-19 | 90 Cypress Way E, Suite 10, NAPLES, FL 34110 | No data |
| LC AMENDMENT | 2014-11-25 | No data | No data |
| Name | Date |
|---|---|
| CORLCDSMEM | 2016-10-31 |
| CORLCDSMEM | 2016-07-11 |
| ANNUAL REPORT | 2016-04-19 |
| ANNUAL REPORT | 2015-04-30 |
| LC Amendment | 2014-11-25 |
| Florida Limited Liability | 2014-10-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
