| Entity Name: | PARADISE COAST MEDICAL GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 May 2022 (3 years ago) |
| Document Number: | L22000217203 |
| FEI/EIN Number | 88-2189396 |
| Address: | 10979 Lost Lake Dr, Apt 221, Naples, FL, 34105, US |
| Mail Address: | 10979 Lost Lake Dr, Apt 221, Naples, FL, 34105, US |
| ZIP code: | 34105 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033898309 | 2023-07-14 | 2023-07-14 | 10979 LOST LAKE DR APT 221, NAPLES, FL, 341053169, US | 10979 LOST LAKE DR APT 221, NAPLES, FL, 341053169, US | |||||||||||||||||
|
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| Phone | +1 561-662-4050 |
Authorized person
| Name | JASON RICHICHI |
| Role | EXECUTIVE DIRECTOR |
| Phone | 8437492220 |
Taxonomy
| Taxonomy Code | 2083P0901X - Public Health & General Preventive Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RICHICHI JASON | Agent | 10979 Lost Lake Dr, Naples, FL, 34105 |
| Name | Role | Address |
|---|---|---|
| RICHICHI JASON D | Managing Member | 10979 Lost Lake Dr, Naples, FL, 34105 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000078700 | PARADISE COAST HEALTH GROUP | ACTIVE | 2022-06-30 | 2027-12-31 | No data | PARADISE COAST MEDICAL GROUP LLC, 21251 PELICAN SOUND DR #101, ESTERO, FL, 33928 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-16 | 10979 Lost Lake Dr, Apt 221, Naples, FL 34105 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-16 | 10979 Lost Lake Dr, Apt 221, Naples, FL 34105 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-16 | 10979 Lost Lake Dr, Apt 221, Naples, FL 34105 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-16 |
| ANNUAL REPORT | 2023-02-07 |
| Florida Limited Liability | 2022-05-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
