| Entity Name: | PACIFICO NATIONAL, II, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 22 Aug 2003 (21 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P03000093554 |
| FEI/EIN Number | 470928792 |
| Address: | 1515 Elizabeth St, Melbourne, FL, 32901, US |
| Mail Address: | 1515 Elizabeth St, Melbourne, FL, 32901, US |
| ZIP code: | 32901 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821033572 | 2006-06-17 | 2018-06-06 | 2275 S BABCOCK ST, MELBOURNE, FL, 329015305, US | 2275 S BABCOCK ST, MELBOURNE, FL, 32901, US | |||||||||||||||||||||
|
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| Phone | +1 800-770-2990 |
| Fax | 8009921322 |
Authorized person
| Name | MARK SANGREE |
| Role | PRESIDENT |
| Phone | 5614452356 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE-FIRST COAST SERVICE OPTIONS, INC. |
| Number | AS032 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SANGREE MARK L | Agent | 1515 Elizabeth St, Melbourne, FL, 32901 |
| Name | Role | Address |
|---|---|---|
| sangree mark L | President | 1515 Elizabeth St, Melbourne, FL, 32901 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000057031 | AMEX PHARMA LAB | EXPIRED | 2018-05-09 | 2023-12-31 | No data | 2275 SOUTH BABCOCK ST, MELBOURNE, FL, 32901 |
| G18000010618 | AMEX PHARMA OUTSOURCING | EXPIRED | 2018-01-19 | 2023-12-31 | No data | 2275 BABCOCK STREET, MELBOURNE, FL, 32901 |
| G14000072208 | AMEX DISEASE MANAGEMENT | EXPIRED | 2014-07-12 | 2019-12-31 | No data | 1515 ELIZABETH STREET, SUITE G, MELBOURNE, FL, 32901 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-12 | 1515 Elizabeth St, Suite L, Melbourne, FL 32901 | No data |
| CHANGE OF MAILING ADDRESS | 2020-05-12 | 1515 Elizabeth St, Suite L, Melbourne, FL 32901 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-05-12 | 1515 Elizabeth St, Suite L, Melbourne, FL 32901 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-04-11 | SANGREE, MARK L | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-05-12 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-04-18 |
| ANNUAL REPORT | 2017-04-21 |
| ANNUAL REPORT | 2016-02-02 |
| ANNUAL REPORT | 2015-03-09 |
| ANNUAL REPORT | 2014-03-03 |
| ANNUAL REPORT | 2013-04-16 |
| ANNUAL REPORT | 2012-04-11 |
| ANNUAL REPORT | 2011-03-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
