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COASTAL INJURY CLINIC, LLC - Florida Company Profile

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Company Details

Entity Name: COASTAL INJURY CLINIC, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 13 Jul 2020 (5 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 13 Dec 2023 (2 years ago)
Document Number: M20000006404
FEI/EIN Number 851849563

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 705 Wells Road, Suite 300, Orange Park, FL, 32073, US
Mail Address: 705 Wells Road, Suite 300, Orange Park, FL, 32073, US
ZIP code: 32073
County: Clay
Place of Formation: DELAWARE

Key Officers & Management

Name Role Address
MH CORPORATE SERVICES, INC. Agent -
POWELL KENNETH Manager 705 Wells Road, Suite 300, Orange Park, FL, 32073
Christman Andrew Chief Executive Officer 705 Wells Road, Suite 300, Orange Park, FL, 32073
Taboh Gregg Chief Operating Officer 705 Wells Road, Suite 300, Orange Park, FL, 32073
PHYSICIANS GROUP SERVICES, P.A. Auth -

National Provider Identifier

NPI Number:
1437768033
Certification Date:
2024-04-26

Authorized Person:

Name:
ANDREW T CHRISTMAN
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
No
Selected Taxonomy:
207X00000X - Orthopaedic Surgery Physician
Is Primary:
No
Selected Taxonomy:
213E00000X - Podiatrist
Is Primary:
No
Selected Taxonomy:
2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician
Is Primary:
Yes

Contacts:

Fax:
8889270401

Events

Event Type Filed Date Value Description
LC AMENDMENT 2023-12-13 - -
CHANGE OF PRINCIPAL ADDRESS 2023-04-24 705 Wells Road, Suite 300, Orange Park, FL 32073 -
CHANGE OF MAILING ADDRESS 2023-04-24 705 Wells Road, Suite 300, Orange Park, FL 32073 -
REGISTERED AGENT NAME CHANGED 2023-04-24 MH Corporate Services, Inc. -
REGISTERED AGENT ADDRESS CHANGED 2021-03-18 14 East Bay Street, Jacksonville, FL 32202 -

Documents

Name Date
ANNUAL REPORT 2024-04-28
LC Amendment 2023-12-13
ANNUAL REPORT 2023-04-24
ANNUAL REPORT 2022-04-28
AMENDED ANNUAL REPORT 2021-03-18
ANNUAL REPORT 2021-03-02
Foreign Limited 2020-07-13

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Date of last update: 02 Jul 2025

Sources: Florida Department of State