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FAMILY MEDICAL CARE OF PALM COAST, LLC - Florida Company Profile

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Company Details

Entity Name: FAMILY MEDICAL CARE OF PALM COAST, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 28 Feb 2025 (6 months ago)
Document Number: L25000103370
Address: 88 EMERALD LAKE DRIVE, PALM COAST, FL, 32137, UN
Mail Address: 88 EMERALD LAKE DRIVE, PALM COAST, FL, 32137, UN
ZIP code: 32137
City: Palm Coast
County: Flagler
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
VICENCIO ANTONIO SIII Agent 88 EMERALD LAKE DRIVE, PALM COAST, FL, 32137
VICENCIO CECILIA H Manager 88 EMERALD LAKE DRIVE, PALM COAST, FL, 32137

National Provider Identifier

NPI Number:
1912177577

Authorized Person:

Name:
DR. ANTONIO SISON VICENCIO III
Role:
SOLE PROPRIETOR
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3865863467

Form 5500 Series

Employer Identification Number (EIN):
260607201
Plan Year:
2022
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
9
Sponsors Telephone Number:

USAspending Awards / Financial Assistance

Date:
2020-06-03
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO PROVIDE LOANS TO RESTORE AS NEARLY AS POSSIBLE THE VICTIMS OF ECONOMIC INJURY TYPE DISASTERS TO PRE-DISASTER CONDITIONS
Obligated Amount:
0.00
Face Value Of Loan:
150000.00
Total Face Value Of Loan:
150000.00
Date:
2020-05-07
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
123977.00
Total Face Value Of Loan:
123977.00

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Date of last update: 01 Aug 2025

Sources: Florida Department of State