| Entity Name: | FIRST COAST INTEGRATIVE PSYCHIATRY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 Apr 2019 (6 years ago) |
| Date of dissolution: | 28 Apr 2024 (10 months ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 28 Apr 2024 (10 months ago) |
| Document Number: | L19000107186 |
| FEI/EIN Number | 83-4580320 |
| Address: | 17 Saint Johns Medical Park Drive, St. Augustine, FL, 32086, US |
| Mail Address: | 189 Belmont Drive, Jacksonville, FL, 32259, US |
| ZIP code: | 32086 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750946158 | 2019-05-01 | 2019-05-01 | 2220 COUNTY ROAD 210 W STE 108-221, JACKSONVILLE, FL, 322594058, US | 304 KINGSLEY LAKE DR STE 601, ST AUGUSTINE, FL, 320923042, US | |||||||||||||||
|
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| Phone | +1 352-339-6311 |
| Phone | +1 352-339-3064 |
Authorized person
| Name | DR. HEATHER LUING |
| Role | MEDICAL DIRECTOR |
| Phone | 3523393064 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| AFLALO DANIEL | Agent | 189 Belmont Drive, Jacksonville, FL, 32259 |
| Name | Role | Address |
|---|---|---|
| Aflalo Daniel | Manager | 189 Belmont Drive, Jacksonville, FL, 32259 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-04-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-28 | 17 Saint Johns Medical Park Drive, St. Augustine, FL 32086 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-28 | 17 Saint Johns Medical Park Drive, St. Augustine, FL 32086 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-28 | 189 Belmont Drive, Jacksonville, FL 32259 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-04-28 |
| ANNUAL REPORT | 2023-03-28 |
| ANNUAL REPORT | 2022-01-22 |
| ANNUAL REPORT | 2021-01-18 |
| ANNUAL REPORT | 2020-01-26 |
| Florida Limited Liability | 2019-04-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
