| Entity Name: | FIRST COAST MEDICAL NETWORK, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 May 2018 (7 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 08 Oct 2020 (4 years ago) |
| Document Number: | L18000131637 |
| FEI/EIN Number | 83-0732864 |
| Address: | 1532 KINGSLEY AVE SUITE 106, ORANGE PARK, FL, 32073, US |
| Mail Address: | 1532 KINGSLEY AVE SUITE 106, ORANGE PARK, FL, 32073, US |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487146890 | 2018-05-31 | 2024-09-04 | 1687 MAJESTIC VIEW LN, FLEMING ISLAND, FL, 320033223, US | 1532 KINGSLEY AVE STE 106, ORANGE PARK, FL, 320734536, US | |||||||||||||||||||||||
|
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| Phone | +1 904-329-1391 |
| Fax | 9045805835 |
Authorized person
| Name | MS. BRENDA CAROL COLEY-GROBES |
| Role | PRESIDENT |
| Phone | 3023733435 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| License Number | L18000131637 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 213E00000X - Podiatrist |
| Is Primary | No |
| Name | Role |
|---|---|
| REGISTERED AGENTS INC | Agent |
| Name | Role | Address |
|---|---|---|
| COLEY-GROBES BRENDA | Manager | 1532 KINGSLEY AVE SUITE 106, ORANGE PARK, FL, 32073 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000114609 | FOOTCARE SOURCE | EXPIRED | 2019-10-23 | 2024-12-31 | No data | 12751 CAMELLIA BAY DR E, JACKSONVILLE, FL, 32223 |
| G19000097300 | FOOT PAIN AND AESTHETICS OF JACKSONVILLE | EXPIRED | 2019-09-05 | 2024-12-31 | No data | 4912 BLANDING BLVD., JACKSONVILLE, FL, 32210 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-29 | 1532 KINGSLEY AVE SUITE 106, ORANGE PARK, FL 32073 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-29 | 1532 KINGSLEY AVE SUITE 106, ORANGE PARK, FL 32073 | No data |
| REINSTATEMENT | 2020-10-08 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-10-08 | REGISTERED AGENTS INC. | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-25 | 7901 4TH STREET NORTH, SUITE 300, ST.PETERSBURG, FL 33702 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-05-01 |
| REINSTATEMENT | 2020-10-08 |
| ANNUAL REPORT | 2019-04-26 |
| Florida Limited Liability | 2018-05-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
