| Entity Name: | COASTAL RHEUMATOLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Jan 2024 (a year ago) |
| Document Number: | L24000011181 |
| Address: | 4331 N. FEDERAL HWY, STE 301, FT. LAUDERDALE, FL, 33308, US |
| Mail Address: | 4331 N. FEDERAL HWY, STE 301, FT. LAUDERDALE, FL, 33308, US |
| ZIP code: | 33308 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083467880 | 2024-04-10 | 2024-04-10 | 4700 SHERIDAN ST STE C, HOLLYWOOD, FL, 330213416, US | 9050 PINES BLVD STE 110, PEMBROKE PINES, FL, 330246461, US | |||||||||||||||||
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| Phone | +1 954-237-3000 |
Authorized person
| Name | NICOLE BEGUIRISTAIN |
| Role | DIRECTOR, BUSINESS DEVELOPMENT |
| Phone | 7863943063 |
Taxonomy
| Taxonomy Code | 207RR0500X - Rheumatology Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QI0500X - Infusion Therapy Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| MATZNER GARY | Agent | 2800 PONCE DE LEON BLVD., STE 1100, CORAL GABLES, FL, 33134 |
| Name | Role | Address |
|---|---|---|
| WEBER PHILIP | Manager | 4331 N. FEDERAL HWY, STE 301, FT. LAUDERDALE, FL, 33308 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000035768 | SOUTH FLORIDA RHEUMATOLOGY | ACTIVE | 2024-03-11 | 2029-12-31 | No data | 4331 N FEDERAL HWY, STE 301, FT LAUDERDALE, FL, 33308 |
| G24000009257 | FLORIDA RHEUMATOLOGY | ACTIVE | 2024-01-16 | 2029-12-31 | No data | 4331 N FEDERAL HIGHWAY, SUITE 301, FORT LAUDERDALE, FL, 33308 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-01-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
