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OLD CITY HEALTH LLC - Florida Company Profile

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Company Details

Entity Name: OLD CITY HEALTH LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 17 Nov 2021 (4 years ago)
Document Number: L21000495448
FEI/EIN Number 87-3651689
Mail Address: PO BOX 24556, JACKSONVILLE, FL, 32241
Address: 100 WHETSTONE PLACE, 208, SAINT AUGUSTINE, FL, 32084
ZIP code: 32084
City: Saint Augustine
County: St. Johns
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
PROVEN SYSTEMS LLC Manager PO BOX 24556, JACKSONVILLE, FL, 32241
FOSS RAFAEL Agent 100 WHETSTONE PLACE, JACKSONVILLE, FL, 32084

National Provider Identifier

NPI Number:
1245008119
Certification Date:
2023-12-19

Authorized Person:

Name:
RAFAEL FOSS
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Fax:
8773973447

Documents

Name Date
ANNUAL REPORT 2024-04-14
ANNUAL REPORT 2023-04-22
ANNUAL REPORT 2022-03-30
Florida Limited Liability 2021-11-17

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Date of last update: 03 Aug 2025

Sources: Florida Department of State