| Entity Name: | FIRST COAST PRIMARY CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 Feb 2007 (18 years ago) |
| Date of dissolution: | 30 Dec 2013 (11 years ago) |
| Last Event: | CORPORATE MERGER |
| Event Date Filed: | 30 Dec 2013 (11 years ago) |
| Document Number: | P07000022428 |
| FEI/EIN Number | 205746243 |
| Address: | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204 |
| Mail Address: | 2 SHIRCLIFF WAY, SUITE 600, JACKSONVILLE, FL, 32204 |
| ZIP code: | 32204 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528197993 | 2007-03-03 | 2011-09-28 | PO BOX 61148, JACKSONVILLE, FL, 322361148, US | 4040 WOODCOCK DR, SUITE 250, JACKSONVILLE, FL, 322072720, US | |||||||||||||||||
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| Phone | +1 904-400-6100 |
| Fax | 9044006102 |
| Phone | +1 904-400-6103 |
Authorized person
| Name | LINDA E GOODEN |
| Role | ADMINISTRATION MANAGER |
| Phone | 9044006100 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MIDDLEBROOKS J. HUGH | Agent | 2 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204 |
| Name | Role | Address |
|---|---|---|
| CHISHOLM MOODY | President | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204 |
| Name | Role | Address |
|---|---|---|
| CHISHOLM MOODY | Director | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204 |
| DARNELL KAREN | Director | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204 |
| CAIN, M.D. ROGERS | Director | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204 |
| SHARPE, M.D. MICHAEL | Director | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204 |
| ZOLLER, M.D. MARK | Director | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204 |
| FLYNN, M.D. RICHARD | Director | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204 |
| Name | Role | Address |
|---|---|---|
| SHARPE, M.D. MICHAEL | Vice Chairman | 1 SHIRCLIFF WAY, JACKSONVILLE, FL, 32204 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000097866 | ST. VINCENT'S PRIMARY CARE | EXPIRED | 2010-10-25 | 2015-12-31 | No data | 2 SHIRCLIFF WAY, JACKSONVILLE, FL, 32082 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| MERGER | 2013-12-30 | No data | CORPORATION WAS PART OF A MERGER. QUALIFIED CORPORATION WAS P10000016609. MERGER NUMBER 300000137103 |
| REGISTERED AGENT NAME CHANGED | 2013-04-25 | MIDDLEBROOKS, J. HUGH | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-22 | 1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204 | No data |
| CHANGE OF MAILING ADDRESS | 2009-04-22 | 1 SHIRCLIFF WAY, JACKSONVILLE, FL 32204 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-04-22 | 2 SHIRCLIFF WAY, STE 600, JACKSONVILLE, FL 32204 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-25 |
| ANNUAL REPORT | 2012-04-30 |
| ANNUAL REPORT | 2011-03-01 |
| ANNUAL REPORT | 2010-04-09 |
| ANNUAL REPORT | 2009-04-22 |
| ANNUAL REPORT | 2008-04-21 |
| Domestic Profit | 2007-02-16 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
