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COASTAL PLUS MEDICAL CENTER, INC.

Company Details

Entity Name: COASTAL PLUS MEDICAL CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 06 Apr 2010 (15 years ago)
Document Number: P10000029970
FEI/EIN Number 272268890
Address: 11761 BEACH BLVD, STE 8, JACKSONVILLE, FL, 32246, US
Mail Address: 11761 BEACH BLVD, STE 8, JACKSONVILLE, FL, 32246, US
ZIP code: 32246
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1407172018 2010-04-08 2019-12-16 11761 BEACH BLVD, SUITE 8, JACKSONVILLE, FL, 322466615, US 11761 BEACH BLVD, SUITE 8, JACKSONVILLE, FL, 322466615, US

Contacts

Phone +1 904-642-3304
Fax 9046428375

Authorized person

Name DR. CARMEN D RIZA
Role OWNER
Phone 9046423304

Taxonomy

Taxonomy Code 261QP2300X - Primary Care Clinic/Center
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COASTAL PLUS MEDICAL CENTER, INC. 401(K) PLAN 2023 272268890 2025-01-17 COASTAL PLUS MEDICAL CENTER, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9046423304
Plan sponsor’s address 11761 BEACH BOULEVARD, SUITE 8, JACKSONVILLE, FL, 32246

Signature of

Role Plan administrator
Date 2025-01-17
Name of individual signing CARMEN RIZA
Valid signature Filed with authorized/valid electronic signature
COASTAL PLUS MEDICAL CENTER, INC. 401(K) PLAN 2022 272268890 2023-10-10 COASTAL PLUS MEDICAL CENTER, INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9046423304
Plan sponsor’s address 11761 BEACH BOULEVARD, SUITE 8, JACKSONVILLE, FL, 32246

Signature of

Role Plan administrator
Date 2023-10-10
Name of individual signing CARMEN RIZA
Valid signature Filed with authorized/valid electronic signature
COASTAL PLUS MEDICAL CENTER, INC. 401(K) PLAN 2021 272268890 2022-10-05 COASTAL PLUS MEDICAL CENTER, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9046423304
Plan sponsor’s address 11761 BEACH BLVD., SUITE 8, JACKSONVILLE, FL, 32246

Signature of

Role Plan administrator
Date 2022-10-05
Name of individual signing CARMEN RIZA
Valid signature Filed with authorized/valid electronic signature
COASTAL PLUS MEDICAL CENTER, INC. 401(K) PLAN 2020 272268890 2021-10-12 COASTAL PLUS MEDICAL CENTER, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9046423304
Plan sponsor’s address 11761 BEACH BLVD., SUITE 8, JACKSONVILLE, FL, 32246
COASTAL PLUS MEDICAL CENTER, INC. 401(K) PLAN 2019 272268890 2020-09-03 COASTAL PLUS MEDICAL CENTER, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9046423304
Plan sponsor’s address 11761 BEACH BLVD., SUITE 8, JACKSONVILLE, FL, 32246

Agent

Name Role Address
RIZA CARMEN D Agent 11761 BEACH BLVD, JACKSONVILLE, FL, 32246

President

Name Role Address
RIZA CARMEN D President 11761 BEACH BLVD, JACKSONVILLE, FL, 32246

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2020-04-20 RIZA, CARMEN D No data
REGISTERED AGENT ADDRESS CHANGED 2020-04-20 11761 BEACH BLVD, STE 8, JACKSONVILLE, FL 32246 No data
CHANGE OF PRINCIPAL ADDRESS 2013-04-16 11761 BEACH BLVD, STE 8, JACKSONVILLE, FL 32246 No data
CHANGE OF MAILING ADDRESS 2013-04-16 11761 BEACH BLVD, STE 8, JACKSONVILLE, FL 32246 No data

Documents

Name Date
ANNUAL REPORT 2024-03-19
ANNUAL REPORT 2023-03-22
ANNUAL REPORT 2022-02-10
ANNUAL REPORT 2021-02-18
ANNUAL REPORT 2020-04-20
ANNUAL REPORT 2019-04-09
ANNUAL REPORT 2018-04-03
ANNUAL REPORT 2017-04-04
ANNUAL REPORT 2016-04-15
ANNUAL REPORT 2015-04-08

Date of last update: 01 Feb 2025

Sources: Florida Department of State