| Entity Name: | GULFCOAST HEALTHCARE GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 Jan 2024 (a year ago) |
| Document Number: | L24000029939 |
| Address: | 2721 DEL PRADO BLVD. S., SUITE 250, CAPE CORAL, FL 33904 |
| Mail Address: | 2721 DEL PRADO BLVD. S., SUITE 250, CAPE CORAL, FL 33904 UN |
| ZIP code: | 33904 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215788229 | 2024-03-28 | 2024-04-05 | 2721 DEL PRADO BLVD S STE 250, CAPE CORAL, FL, 339045710, US | 2721 DEL PRADO BLVD S STE 250, CAPE CORAL, FL, 339045710, US | |||||||||||||||
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| Phone | +1 239-574-5559 |
| Fax | 2395749454 |
Authorized person
| Name | LARRY DEAN JOHNSON |
| Role | PRESIDENT |
| Phone | 2395745559 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JOHNSON, LARRY D | Agent | 2721 DEL PRADO BLVD. S., SUITE 250, CAPE CORAL, FL 33904 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, LARRY D | Manager | 2721 DEL PRADO BLVD. S., SUITE 250, CAPE CORAL, FL 33904 |
| Name | Role | Address |
|---|---|---|
| KNAPP, LAURA K | Authorized Member | 43274 WATER BIRD WAY, PUNTA GORDA, FL 33982 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-01-16 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
