| Entity Name: | COASTAL CONCIERGE INTERNAL MEDICINE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 17 Mar 2021 (4 years ago) |
| Document Number: | L21000126225 |
| FEI/EIN Number | 86-2792020 |
| Address: | 1411 NORTH FLAGLER DRIVE, Suite 6700, WEST PALM BEACH, FL 33401 |
| Mail Address: | 1411 NORTH FLAGLER DRIVE, Suite 6700, WEST PALM BEACH, FL 33401 |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376125302 | 2021-04-28 | 2021-10-13 | 1411 N FLAGLER DR STE 6700, WEST PALM BEACH, FL, 334013417, US | 1411 N FLAGLER DR STE 6700, WEST PALM BEACH, FL, 334013417, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 561-768-4018 |
| Fax | 5617604583 |
Authorized person
| Name | DR. JANA L MCKENZIE |
| Role | PRESIDENT/OWNER |
| Phone | 5618208580 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MCKENZIE, JANA L, DR. | Agent | 1411 NORTH FLAGLER DRIVE, Suite 6700, WEST PALM BEACH, FL 33401 |
| Name | Role | Address |
|---|---|---|
| MCKENZIE, JANA L, DR. | President | 1411 NORTH FLAGLER DRIVE, Suite 6700 WEST PALM BEACH, FL 33401 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-07 | 1411 NORTH FLAGLER DRIVE, Suite 6700, WEST PALM BEACH, FL 33401 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-02 |
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-04-06 |
| ANNUAL REPORT | 2022-03-07 |
| Florida Limited Liability | 2021-03-17 |
Date of last update: 13 Feb 2025
Sources: Florida Department of State
