| Entity Name: | FIRST COAST PEDIATRIC INFECTIOUS DISEASE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 16 Dec 2015 (9 years ago) |
| Date of dissolution: | 30 Jul 2019 (6 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 Jul 2019 (6 years ago) |
| Document Number: | L15000208917 |
| FEI/EIN Number | 81-0839573 |
| Address: | 1555 KINGSLEY AVE, SUITE # 201, JACKSONVILLE, FL, 32073 |
| Mail Address: | 1555 KINGSLEY AVE, SUITE # 201, ORANGE PARK, FL, 32073 |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699137182 | 2016-03-23 | 2016-03-23 | 1555 KINGSLEY AVE, STE. 201, ORANGE PARK, FL, 320734560, US | 1555 KINGSLEY AVE, STE. 201, ORANGE PARK, FL, 320734560, US | |||||||||||||||||||||||||||
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| Phone | +1 904-398-5614 |
| Fax | 9043985617 |
Authorized person
| Name | SEBASTIAN R STANCIU |
| Role | OWNER |
| Phone | 9043985614 |
Taxonomy
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| License Number | ME89939 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2080P0208X - Pediatric Infectious Diseases Physician |
| License Number | ME89939 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Stanciu Sebastian R | Agent | 10365 HOOD ROAD SOUTH, JACKSONVILLE, FL, 32257 |
| Name | Role | Address |
|---|---|---|
| STANCIU SEBASTIAN R | Manager | 1555 KINGSLEY AVE # 201, ORANGE PARK, FL, 32073 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2019-07-30 | No data | No data |
| REINSTATEMENT | 2016-10-20 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-20 | Stanciu, Sebastian R | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-10-20 | 10365 HOOD ROAD SOUTH, SUITE #104, JACKSONVILLE, FL 32257 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2019-07-30 |
| ANNUAL REPORT | 2018-01-18 |
| ANNUAL REPORT | 2017-04-07 |
| REINSTATEMENT | 2016-10-20 |
| Florida Limited Liability | 2015-12-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
