| Entity Name: | GOLD COAST CHIROPRACTIC & REHAB, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 Jun 2005 (20 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 years ago) |
| Document Number: | P05000092976 |
| FEI/EIN Number | 203107856 |
| Address: | 4210 DEL PRADO BLVD S., CAPE CORAL, FL, 33904, US |
| Mail Address: | 4210 DEL PRADO BLVD S., CAPE CORAL, FL, 33904, US |
| ZIP code: | 33904 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497930382 | 2008-01-09 | 2008-06-05 | 4210 DEL PRADO BLVD S, CAPE CORAL, FL, 339047166, US | 4210 DEL PRADO BLVD S, CAPE CORAL, FL, 339047166, US | |||||||||||||||||||||||||
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| Phone | +1 239-542-7660 |
Authorized person
| Name | DR. MARK MARIEN |
| Role | OWNER |
| Phone | 2395427660 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILRAOD MEDICARE PART B GROUP NUMBER |
| Number | DE1877 |
| State | FL |
| Issuer | RAILROAD MEDICARE PART B PTAN |
| Number | P00277193 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARIEN MARK C | Agent | 4210 DEL PRADO BLVD S., CAPE CORAL, FL, 33904 |
| Name | Role | Address |
|---|---|---|
| MARIEN MARK C | President | 4210 DEL PRADO BLVD S., CAPE CORAL, FL, 33904 |
| Name | Role | Address |
|---|---|---|
| MARIEN MARK C | Secretary | 4210 DEL PRADO BLVD S., CAPE CORAL, FL, 33904 |
| Name | Role | Address |
|---|---|---|
| MARIEN MARK C | Treasurer | 4210 DEL PRADO BLVD S., CAPE CORAL, FL, 33904 |
| Name | Role | Address |
|---|---|---|
| MARIEN MARK C | Director | 4210 DEL PRADO BLVD S., CAPE CORAL, FL, 33904 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-04-29 | 4210 DEL PRADO BLVD S., CAPE CORAL, FL 33904 | No data |
| CHANGE OF MAILING ADDRESS | 2008-04-29 | 4210 DEL PRADO BLVD S., CAPE CORAL, FL 33904 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-04-29 | 4210 DEL PRADO BLVD S., CAPE CORAL, FL 33904 | No data |
| AMENDED AND RESTATEDARTICLES | 2005-10-06 | No data | No data |
| AMENDMENT AND NAME CHANGE | 2005-10-05 | GOLD COAST CHIROPRACTIC & REHAB, P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2009-06-03 |
| ANNUAL REPORT | 2008-04-29 |
| ANNUAL REPORT | 2007-09-11 |
| ANNUAL REPORT | 2006-01-10 |
| Amended and Restated Articles | 2005-10-06 |
| Amendment and Name Change | 2005-10-05 |
| Domestic Profit | 2005-06-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
