| Entity Name: | CRESTVIEW URGENT CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 08 May 2009 (16 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 01 Sep 2017 (7 years ago) |
| Document Number: | P09000041474 |
| FEI/EIN Number | 800409574 |
| Address: | 2400 S. Ferdon Blvd, Suite A, CRESTVIEW, FL, 32536, US |
| Mail Address: | 132 MONAHAN DRIVE, FT. WALTON BEACH, FL, 32547 |
| ZIP code: | 32536 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144458647 | 2009-06-23 | 2010-08-27 | 1502 S FERDON BLVD, CRESTVIEW, FL, 325368444, US | 1502 S FERDON BLVD, CRESTVIEW, FL, 325368444, US | |||||||||||||||||||
|
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| Phone | +1 850-398-8668 |
| Phone | +1 850-398-1079 |
Authorized person
| Name | CHARLES JOSEPH CLANCY |
| Role | PHYSICIAN ASSISTANT |
| Phone | 8503988668 |
Taxonomy
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| License Number | ME93880 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CLANCY SHERI | Agent | 132 MONAHAN DRIVE, FT. WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| CLANCY Sheri | President | 132 MONAHAN DRIVE, FT. WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| CLANCY SHERI | Treasurer | 132 MONAHAN DR, FORT WALTON BEACH, FL, 32547 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000103491 | PERDIDO URGENT CARE | ACTIVE | 2017-09-18 | 2027-12-31 | No data | 132 MONAHAN DR., FORT WALTON BEACH, FL, 32547 |
| G17000103047 | NICEVILLE URGENT CARE | ACTIVE | 2017-09-15 | 2027-12-31 | No data | 132 MONAHAN DR., FORT WALTON BEACH, FL, 32547 |
| G17000019029 | NICEVILLE URGENT CARE | EXPIRED | 2017-02-21 | 2022-12-31 | No data | 132 MONAHAN DR, FORT WALTON BEACH, FL, 32547 |
| G13000087584 | PERDIDO URGENT CARE | EXPIRED | 2013-09-04 | 2018-12-31 | No data | 132 MONAHAN DRIVE, FORT WALTON BEACH, FL, 32547 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2017-09-01 | No data | No data |
| AMENDMENT | 2014-04-02 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-08-14 | CLANCY, SHERI | No data |
| AMENDMENT | 2013-08-14 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-01 | 2400 S. Ferdon Blvd, Suite A, CRESTVIEW, FL 32536 | No data |
| AMENDMENT | 2009-09-15 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2009-08-20 | 2400 S. Ferdon Blvd, Suite A, CRESTVIEW, FL 32536 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-08-20 | 132 MONAHAN DRIVE, FT. WALTON BEACH, FL 32547 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-14 |
| ANNUAL REPORT | 2023-04-13 |
| ANNUAL REPORT | 2022-04-17 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-04-10 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-04-13 |
| Amendment | 2017-09-01 |
| ANNUAL REPORT | 2017-03-29 |
| ANNUAL REPORT | 2016-04-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
