| Entity Name: | ACUTE CARE PEDIATRICS OF PALM COAST, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
ACUTE CARE PEDIATRICS OF PALM COAST, PA is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| 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: | 28 Jul 2004 (21 years ago) |
| Last Event: | AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 06 Jan 2006 (19 years ago) |
| Document Number: | P04000110898 |
| FEI/EIN Number |
020728089
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 1859 SW Newland Way, Lake City, FL, 32025, US |
| Address: | 397 SW PALM COAST PARKWAY -, UNIT 302- 303, PALM COAST, FL, 32137 |
| ZIP code: | 32137 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225065717 | 2006-06-28 | 2023-07-31 | 397 PALM COAST PARKWAY SW, UNIT 303, PALM COAST, FL, 32137, US | 397 PALM COAST PARKWAY SW, UNIT 303, PALM COAST, FL, 32137, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 386-447-7337 |
| Fax | 3864477348 |
Authorized person
| Name | MRS. CHRISTINE TIU |
| Role | OFFICE MANAGER |
| Phone | 3864477337 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME 0075674 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QR1300X - Rural Health Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD OF FLORIDA |
| Number | 009US |
| State | FL |
| Issuer | MEDICAID |
| Number | 000387200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Marcelino, Amie | Agent | 1859 SW Newland Way, Lake City, FL, 32025 |
| SANTELICES SAMUEL M | Manager | 8652 SW 42nd Place, Gainesville, FL, 32608 |
| SANTELICES SAMUEL M | Director | 8652 SW 42nd Place, Gainesville, FL, 32608 |
| Tiu Christine | Manager | 12 Floyd Ct, Palm Coast, FL, 32137 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-05-03 | 397 SW PALM COAST PARKWAY -, UNIT 302- 303, PALM COAST, FL 32137 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-05-03 | 1859 SW Newland Way, Lake City, FL 32025 | - |
| REGISTERED AGENT NAME CHANGED | 2024-05-03 | Marcelino, Amie | - |
| CHANGE OF PRINCIPAL ADDRESS | 2012-01-07 | 397 SW PALM COAST PARKWAY -, UNIT 302- 303, PALM COAST, FL 32137 | - |
| AMENDMENT AND NAME CHANGE | 2006-01-06 | ACUTE CARE PEDIATRICS OF PALM COAST, PA | - |
| CANCEL ADM DISS/REV | 2005-12-01 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | - | - |
| NAME CHANGE AMENDMENT | 2004-11-10 | ACUTE CARE PEDIATRICS OF JACKSONVILLE, PA | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| AMENDED ANNUAL REPORT | 2024-05-03 |
| AMENDED ANNUAL REPORT | 2024-03-20 |
| ANNUAL REPORT | 2024-02-26 |
| ANNUAL REPORT | 2023-02-05 |
| ANNUAL REPORT | 2022-01-17 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-01-11 |
| ANNUAL REPORT | 2019-03-01 |
| ANNUAL REPORT | 2018-03-10 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2007307406 | 2020-05-05 | 0491 | PPP | 397 SW Palm Coast Parkway unit 303, Palm Coast, FL, 32137-4776 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
