| Entity Name: | ADVENTHEALTH PALM COAST PARKWAY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Active |
| Date Filed: | 05 Mar 2021 (4 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 10 Jun 2022 (3 years ago) |
| Document Number: | N21000004320 |
| FEI/EIN Number | 88-2288563 |
| Address: | 900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714 |
| Mail Address: | 900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714 |
| ZIP code: | 32714 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861102345 | 2022-11-25 | 2024-01-18 | 770 W GRANADA BLVD STE 203, ORMOND BEACH, FL, 321745179, US | 1 ADVENTHEALTH WAY, PALM COAST, FL, 32127, US | |||||||||||||||||
|
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| Phone | +1 386-312-4252 |
| Fax | 3866762560 |
| Phone | +1 386-586-4301 |
Authorized person
| Name | MARK RATHBUN |
| Role | CFO |
| Phone | 3865864301 |
Taxonomy
| Taxonomy Code | 282N00000X - General Acute Care Hospital |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Bromme, Jeffrey S | Agent | 900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714 |
| Name | Role | Address |
|---|---|---|
| Rathbun, Mark | Director | 900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714 |
| De Aquino, Walmir | Director | 60 Memorial Medical Way, Palm Coast, FL 32164 |
| Bales-Chubb, Denyse | Director | 60 Memorial Medical Way Palm Coast,, FL 32164 US Palm Coast, FL 32164 |
| Gregory, Gregory, Ph.D | Director | 550 E. Rollins Street, Orlando, FL 32803 |
| Name | Role | Address |
|---|---|---|
| Rathbun, Mark | Secretary | 900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714 |
| Name | Role | Address |
|---|---|---|
| De Aquino, Walmir | Treasurer | 60 Memorial Medical Way, Palm Coast, FL 32164 |
| Name | Role | Address |
|---|---|---|
| Bales-Chubb, Denyse | President | 60 Memorial Medical Way Palm Coast,, FL 32164 US Palm Coast, FL 32164 |
| Name | Role | Address |
|---|---|---|
| Bales-Chubb, Denyse | Chairman | 60 Memorial Medical Way Palm Coast,, FL 32164 US Palm Coast, FL 32164 |
| Name | Role | Address |
|---|---|---|
| Gregory, Gregory, Ph.D | Chairperson | 550 E. Rollins Street, Orlando, FL 32803 |
| Name | Role | Address |
|---|---|---|
| Addiscott, Lynn | Assistant Secretary | 900 Hope Way, Altamonte Springs, FL 32714 |
| Berrios, Toni | Assistant Secretary | 900 Hope Way, Altamonte Springs, FL 32714 |
| Saunders, Michael | Assistant Secretary | 900 Hope Way, Altamonte Springs, FL 32714 |
| Thomas, Deborah | Assistant Secretary | 1061 Medical Center Drive Suite 311, Orange City, FL 32763 |
| Vincent, Haney | Assistant Secretary | 900 Hope Way, Altamonte Springs Fl, FL 32714 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000099603 | ADVENTHEALTH IMAGING PALM COAST PARKWAY | ACTIVE | 2023-08-25 | 2028-12-31 | No data | 1 ADVENTHEALTH WAY, PALM COAST, FL, 32137 |
| G23000093965 | ADVENTHEALTH PALM COAST PARKWAY MEDICAL OFFICE BUILDING | ACTIVE | 2023-08-11 | 2028-12-31 | No data | 3 ADVENTHEALTH WAY, PALM COAST, FL, 32137 |
| G22000149690 | ADVENTHEALTH PALM COAST PARKWAY | ACTIVE | 2022-12-06 | 2027-12-31 | No data | 1 ADVENTHEALTH WAY, PALM COAST, FL, 32137 |
| G22000149782 | ADVENTHEALTH LAB | ACTIVE | 2022-12-06 | 2027-12-31 | No data | 1 ADVENTHEALTH WAY, PALM COAST, FL, 32137 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-01-25 | Bromme, Jeffrey S | No data |
| NAME CHANGE AMENDMENT | 2022-06-10 | ADVENTHEALTH PALM COAST PARKWAY, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-02 |
| ANNUAL REPORT | 2024-04-25 |
| AMENDED ANNUAL REPORT | 2023-09-12 |
| ANNUAL REPORT | 2023-01-25 |
| Name Change | 2022-06-10 |
| ANNUAL REPORT | 2022-04-28 |
| Domestic Non-Profit | 2021-03-05 |
Date of last update: 14 Jan 2025
Sources: Florida Department of State
