| Entity Name: | COCONUT GROVE PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 21 Jun 2007 (18 years ago) |
| Document Number: | P07000072021 |
| FEI/EIN Number | 26-0396792 |
| Mail Address: | 3380 CRYSTAL COURT, COCONUT GROVE, FL 33133 |
| Address: | 3001 SW 27 AVENUE, CU 102, MIAMI, FL 33133 |
| ZIP code: | 33133 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194979286 | 2008-11-17 | 2015-12-29 | 3001 SW 27TH AVE, SUITE 102, COCONUT GROVE, FL, 331334663, US | 3001 SW 27TH AVE, SUITE 102, COCONUT GROVE, FL, 331334663, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-442-0211 |
| Fax | 3054428185 |
Authorized person
| Name | JAMES LYONS |
| Role | MANAGER |
| Phone | 3054420211 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH23708 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2117822 |
| Name | Role | Address |
|---|---|---|
| VERGARA, ADRIANA | Agent | 3380 CRYSTAL COURT, COCONUT GROVE, FL 33133 |
| Name | Role | Address |
|---|---|---|
| VERGARA, ADRIANA | President | 3380 CRYSTAL COURT, MIAMI, FL 33133 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2015-04-28 | 3001 SW 27 AVENUE, CU 102, MIAMI, FL 33133 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-27 |
| ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-03-02 |
| ANNUAL REPORT | 2017-04-29 |
| ANNUAL REPORT | 2016-04-18 |
| ANNUAL REPORT | 2015-04-28 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
