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MEMORIAL HOSPITAL FLAGLER, INC.

Company Details

Entity Name: MEMORIAL HOSPITAL FLAGLER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 31 May 1989 (36 years ago)
Document Number: N32597
FEI/EIN Number 592951990
Address: 60 MEMORIAL MEDICAL PARKWAY, PALM COAST, FL, 32164, US
Mail Address: 60 MEMORIAL MEDICAL PARKWAY, PALM COAST, FL, 32164, US
ZIP code: 32164
County: Flagler
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1689325938 2022-01-18 2022-08-12 770 W GRANADA BLVD STE 203, ORMOND BEACH, FL, 321745179, US 60 MEMORIAL MEDICAL PKWY STE 500, PALM COAST, FL, 321645980, US

Contacts

Phone +1 386-231-4252
Fax 3866762560
Phone +1 386-586-4200

Authorized person

Name MARK RATHBUN
Role CFO
Phone 3865864301

Taxonomy

Taxonomy Code 261QR0404X - Cardiac Rehabilitation Clinic/Center
Is Primary Yes

Agent

Name Role Address
BROMME JEFF Agent 900 HOPE WAY, ALTAMONTE SPRINGS, FL, 32714

Assi

Name Role Address
Vincent Haney L Assi 900 HOPE WAY, ALTAMONTE SPRINGS, FL, 32714
Foltz Robert C Assi 26300 Siena Drive, Bonita Springs, FL, 34134
Graff Jeff Assi 900 Hope Way, Altamonte Springs, FL, 32714
Rathbun Paul Assi 900 Hope Way, Altamonte Springs, FL, 32714
ADDISCOTT LYNN C Assi 900 HOPE WAY, ALTAMONTE SPRINGS, FL, 32714

Director

Name Role Address
Gregory Audrey C Director 550 E. Rollins Street, Orlando, FL, 32803

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000130321 ADVENTHEALTH RADIATION ONCOLOGY FREYTAG CANCER CENTER ACTIVE 2024-10-23 2029-12-31 No data 1 MEMORIAL MEDICAL PARKWAY, SUITE 100, PALM COAST, FL, 32164
G24000063259 ADVENTHEALTH MEDICAL GROUP GENERAL SURGERY AT PALM COAST ACTIVE 2024-05-15 2029-12-31 No data 61 MEMORIAL MEDICAL PARKWAY, SUITE 1800A, PALM COAST, FL, 32164
G24000027859 ADVENTHEALTH MEDICAL GROUP UROLOGY AT PALM COAST ACTIVE 2024-02-21 2029-12-31 No data 61 MEMORIAL MEDICAL PARKWAY, SUITE 3807, PALM COAST, FL, 32164
G22000099012 ADVENTHEALTH PALM COAST PARKWAY ACTIVE 2022-08-22 2027-12-31 No data 1 ADVENTHEALTH WAY, PALM COAST, FL, 32137
G22000017070 ADVENTHEALTH MEDICAL GROUP ORTHOPEDICS & SPORTS MEDICINE AT TOWN MEDICAL ACTIVE 2022-02-10 2027-12-31 No data 21 HOSPITAL DRIVE SUITE 110, PALM COAST, FL, 32164
G21000140384 ADVENTHEALTH MEDICAL GROUP GENERAL SURGERY AT PALM COAST ACTIVE 2021-10-19 2026-12-31 No data 61 MEMORIAL MEDICAL PARKWAY, SUITE 3807, PALM COAST, FL, 32164
G21000140381 ADVENTHEALTH MEDICAL GROUP GENERAL SURGERY AT PALM COAST ACTIVE 2021-10-19 2026-12-31 No data 61 MEMORIAL MEDICAL PARKWAY, SUITE 3806, PALM COAST, FL, 32164
G19000014944 ADVENTHEALTH MEDICAL GROUP FAMILY MEDICINE AT PALM COAST EXPIRED 2019-01-28 2024-12-31 No data 21 HOSPITAL DRIVE, SUITE 290, PALM COAST, FL, 32164
G18000129687 ADVENTHEALTH MEDICAL GROUP NEUROLOGY AT PALM COAST ACTIVE 2018-12-07 2028-12-31 No data 61 MEMORIAL MEDICAL PARKWAY, SUITE 2808, PALM COAST, FL, 32164
G18000128671 ADVENTHEALTH MEDICAL GROUP FAMILY MEDICINE AT PALM COAST EXPIRED 2018-12-05 2023-12-31 No data 61 MEMORIAL MEDICAL PARKWAY, SUITE 2806, PALM COAST, FL, 32164

Events

Event Type Filed Date Value Description
AMENDMENT 2019-08-08 No data No data
AMENDMENT AND NAME CHANGE 2009-09-22 MEMORIAL HOSPITAL FLAGLER, INC. No data
AMENDED AND RESTATEDARTICLES 2000-09-26 No data No data

Date of last update: 02 Jan 2025

Sources: Florida Department of State