| Entity Name: | COASTAL MOBILE ULTRASOUND, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 10 Mar 2022 (3 years ago) |
| Document Number: | L22000122645 |
| FEI/EIN Number | 88-1467956 |
| Address: | 4 LONG LAKE WAY, PALM COAST, FL 32137 |
| Mail Address: | 4 LONG LAKE WAY, PALM COAST, FL 32137 |
| ZIP code: | 32137 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376228429 | 2023-06-16 | 2023-06-16 | 4 LONG LAKE WAY, PALM COAST, FL, 321371617, US | 4 LONG LAKE WAY, PALM COAST, FL, 321371617, US | |||||||||||||
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| Phone | +1 904-494-8560 |
Authorized person
| Name | VANESSA FERKETICH |
| Role | OWNER |
| Phone | 9044948560 |
Taxonomy
| Taxonomy Code | 2085U0001X - Diagnostic Ultrasound Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FERKETICH, VANESSA M | Agent | 4 LONG LAKE WAY, PALM COAST, FL 32137 |
| Name | Role | Address |
|---|---|---|
| FERKETICH, VANESSA M | Manager | 4 LONG LAKE WAY, PALM COAST, FL 32137 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-05 |
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-01-07 |
| Florida Limited Liability | 2022-03-10 |
Date of last update: 12 Feb 2025
Sources: Florida Department of State
