| Entity Name: | FIRST COAST PATHOLOGY ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 02 Sep 2015 (9 years ago) |
| Date of dissolution: | 16 Jan 2024 (a year ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 16 Jan 2024 (a year ago) |
| Document Number: | L15000150567 |
| FEI/EIN Number | 47-4966641 |
| Address: | 9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257 |
| Mail Address: | 460 E Kesley Ln, St.Johns, FL 32259 |
| ZIP code: | 32257 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700255841 | 2015-09-18 | 2015-09-18 | 9102 DUCALE WAY APT 204, PALM BEACH GARDENS, FL, 334188164, US | 9421 WAYPOINT PLACE, JACKSONVILLE, FL, 32257, US | |||||||||||||||||||||||
|
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| Phone | +1 904-302-3553 |
Authorized person
| Name | VIRENDRA DESAI |
| Role | PHYSICIAN |
| Phone | 9043023553 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | ME 93419 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 2764806 00 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DESAI, VIRENDRA | Agent | 9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257 |
| Name | Role | Address |
|---|---|---|
| DESAI, VIRENDRA D | Authorized Member | 9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-01-16 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-16 | 9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257 | No data |
| LC AMENDMENT | 2018-04-02 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-04-02 | DESAI, VIRENDRA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-02 | 9421 WAYPOINT PLACE, JACKSONVILLE, FL 32257 | No data |
| REINSTATEMENT | 2016-10-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-01-16 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-01-16 |
| ANNUAL REPORT | 2020-01-18 |
| ANNUAL REPORT | 2019-02-24 |
| LC Amendment | 2018-04-02 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-01-14 |
| REINSTATEMENT | 2016-10-30 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
