| Entity Name: | FORT PIERCE FAMILY CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
FORT PIERCE FAMILY CARE, INC. 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: | 09 Feb 2010 (15 years ago) |
| Document Number: | P10000012007 |
| FEI/EIN Number |
271880312
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 3851 VIRGINIA AVENUE, FORT PIERCE, FL, 34981, US |
| Address: | 3851 VIRGINIA AVENUE, FORT PIERCE, FL, 34981 |
| ZIP code: | 34981 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710271333 | 2011-05-31 | 2011-05-31 | 3709 OAK RIDGE LN, WESTON, FL, 333313706, US | 3851 VIRGINIA AVENUE, FORT PIERCE, FL, 34981, US | |||||||||||||||||
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| Phone | +1 954-661-8151 |
Authorized person
| Name | DR. JERRY JACOBSON |
| Role | PHYSICIAN |
| Phone | 9546618151 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME0059609 |
| State | FL |
| Is Primary | Yes |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6RWG9 | Active | Non-Manufacturer | 2012-06-15 | 2015-08-01 | - | - | |||||||||||||||
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| POC | JERRY JACOBSON |
| Phone | +1 772-882-4919 |
| Fax | +1 772-882-4893 |
| Address | 3851 VIRGINIA AVE, FORT PIERCE, FL, 34981 5515, UNITED STATES |
Ownership of Offeror Information
| Highest Level Owner | Information not Available |
|---|
| Immediate Level Owner | Information not Available |
|---|
| List of Offerors (0) | Information not Available |
|---|
| Name | Role | Address |
|---|---|---|
| JACOBSON JERRY | Vice President | 3851 VIRGINIA AVENUE, FORT PIERCE, FL, 34981 |
| JACOBSON JERRY | Agent | 3851 VIRGINIA AVENUE, FORT PIERCE, FL, 34981 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000060999 | FORT PIERCE PHARMACY | EXPIRED | 2011-06-17 | 2016-12-31 | - | 3851 VIRGINIA AVENUE, FORT PIERCE, FL, 34981 |
| G10000013671 | FORT PIERCE URGENT CARE | ACTIVE | 2010-02-10 | 2025-12-31 | - | 3851 VIRGINIA AVENUE, FORT PIERCE, FL, 34981 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2016-01-25 | 3851 VIRGINIA AVENUE, FORT PIERCE, FL 34981 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2016-01-25 | 3851 VIRGINIA AVENUE, FORT PIERCE, FL 34981 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-21 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-03-04 |
| ANNUAL REPORT | 2020-03-15 |
| ANNUAL REPORT | 2019-02-17 |
| ANNUAL REPORT | 2018-01-19 |
| ANNUAL REPORT | 2017-01-20 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-03-14 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PO | AWARD | AG4232P120043 | 2012-08-01 | 2012-08-01 | 2012-08-01 | |||||||||||||||||||||
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| Title | IGF::OT::IGF OMSP - 34 EMPLOYEE PHYSICALS |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q201: MEDICAL- GENERAL HEALTH CARE |
Recipient Details
| Recipient | FORT PIERCE FAMILY CARE |
| UEI | SRCMAH52JEB5 |
| Legacy DUNS | 004248633 |
| Recipient Address | 3851 VIRGINIA AVE, FORT PIERCE, 349815515, UNITED STATES |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5042688301 | 2021-01-23 | 0455 | PPS | 3851 Virginia Ave, Fort Pierce, FL, 34981-5515 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2472387207 | 2020-04-16 | 0455 | PPP | 3851 VIRGINIA AVE, FORT PIERCE, FL, 34981-5515 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
