| Entity Name: | BEACHSIDE PRIMARY CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Aug 2022 (2 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 02 Nov 2022 (2 years ago) |
| Document Number: | L22000375952 |
| FEI/EIN Number | 883899090 |
| Address: | 1825 3rd St N, Jacksonville Beach, FL, 32250, US |
| Mail Address: | 1825 3rd St N, Jacksonville Beach, FL, 32250, US |
| ZIP code: | 32250 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386364032 | 2022-09-01 | 2022-12-16 | 1825 3RD ST N STE B, JACKSONVILLE BEACH, FL, 322504840, US | 1825 3RD ST N STE B, JACKSONVILLE BEACH, FL, 322504840, US | |||||||||||||||
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| Phone | +1 904-595-5826 |
| Fax | 9045955827 |
Authorized person
| Name | DR. DEBORAH GHANDOUR |
| Role | PRESIDENT |
| Phone | 9045955826 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GHANDOUR DEBORAH L | Agent | 1825 3RD ST N, JACKSONVILLE BEACH, FL, 32250 |
| Name | Role | Address |
|---|---|---|
| GHANDOUR DEBORAH L | Authorized Person | 1825 3RD ST N, SUITE B, JACKSONVILLE BEACH, FL, 32250 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-13 | 1825 3rd St N, Suite B, Jacksonville Beach, FL 32250 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-13 | 1825 3rd St N, Suite B, Jacksonville Beach, FL 32250 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-13 | 1825 3RD ST N, SUITE B, JACKSONVILLE BEACH, FL 32250 | No data |
| LC STMNT OF RA/RO CHG | 2022-11-02 | No data | No data |
| LC STMNT OF RA/RO CHG | 2022-09-06 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-05 |
| ANNUAL REPORT | 2024-01-04 |
| ANNUAL REPORT | 2023-01-13 |
| CORLCRACHG | 2022-11-02 |
| CORLCRACHG | 2022-09-06 |
| Florida Limited Liability | 2022-08-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
