| Entity Name: | FLAGLER PSYCHIATRIC ASSOCIATES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 20 Jun 2017 (8 years ago) |
| Document Number: | L17000133841 |
| FEI/EIN Number | 82-1952875 |
| Address: | 6277 A1A S., UNIT 202, ST. AUGUSTINE, FL 32080 |
| Mail Address: | 6277 A1A S., UNIT 202, ST. AUGUSTINE, FL 32080 |
| ZIP code: | 32080 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386163939 | 2017-09-14 | 2022-07-21 | 6277 A1A S UNIT 202, ST AUGUSTINE, FL, 320807515, US | 6277 A1A S UNIT 202, ST AUGUSTINE, FL, 320807515, US | |||||||||||||||||||
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| Phone | +1 904-907-1070 |
| Fax | 9496605868 |
Authorized person
| Name | DR. BENJAMIN WATKINS LACY V |
| Role | OWNER |
| Phone | 9049071070 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME128307 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LACY, BENJAMIN W, V | Agent | 6277 A1A S., UNIT 202, ST. AUGUSTINE, FL 32080 |
| Name | Role | Address |
|---|---|---|
| LACY, BENJAMIN, V | Authorized Member | 6277 A1A S., UNIT 202 ST. AUGUSTINE, FL 32080 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-01 | 6277 A1A S., UNIT 202, ST. AUGUSTINE, FL 32080 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-12 | 6277 A1A S., UNIT 202, ST. AUGUSTINE, FL 32080 | No data |
| CHANGE OF MAILING ADDRESS | 2019-02-10 | 6277 A1A S., UNIT 202, ST. AUGUSTINE, FL 32080 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-02-14 |
| ANNUAL REPORT | 2022-01-12 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-02-05 |
| ANNUAL REPORT | 2019-02-10 |
| ANNUAL REPORT | 2018-04-18 |
| Florida Limited Liability | 2017-06-20 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1660887207 | 2020-04-15 | 0491 | PPP | 6277 A1A S STE 202, SAINT AUGUSTINE, FL, 32080-7515 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 18 Feb 2025
Sources: Florida Department of State
