| Entity Name: | LESLIE F. COUGHLAN, NP, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 13 Jan 2014 (11 years ago) |
| Date of dissolution: | 13 Jan 2020 (5 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 13 Jan 2020 (5 years ago) |
| Document Number: | P14000003841 |
| FEI/EIN Number | 46-4541504 |
| Address: | 10075 Jog Rd, Suite 202, BOYNTON BEACH, FL, 33437, US |
| Mail Address: | 10075 Jog Rd, Suite 202, BOYNTON BEACH, FL, 33437, US |
| ZIP code: | 33437 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669898896 | 2014-03-12 | 2014-03-12 | 2623 S. SEACREST BLVD. SUITE.116, BOYNTON BEACH, FL, 334357531, US | 2623 S. SEACREST BLVD., SUITE.116, BOYNTON BEACH, FL, 334357531, US | |||||||||||||
|
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| Phone | +1 561-509-6109 |
Authorized person
| Name | LESLIE F COUGHLAN |
| Role | OWNER |
| Phone | 5615096109 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| COUGHLAN DEVON G | Agent | 301 CLEMATIS STREET, WEST PALM BEACH, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| COUGHLAN LESLIE F | President | 10075 Jog Rd, BOYNTON BEACH, FL, 33437 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000109826 | COUGHLAN & MURRAY FAMILY PRACTICE | EXPIRED | 2015-10-28 | 2020-12-31 | No data | 2623 S. SEACREST BLVD., SUITE 116, BOYNTON BEACH, FL, 33435 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2020-01-13 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-06-25 | 10075 Jog Rd, Suite 202, BOYNTON BEACH, FL 33437 | No data |
| CHANGE OF MAILING ADDRESS | 2018-06-25 | 10075 Jog Rd, Suite 202, BOYNTON BEACH, FL 33437 | No data |
| AMENDMENT AND NAME CHANGE | 2017-02-06 | LESLIE F. COUGHLAN, NP, PA | No data |
| NAME CHANGE AMENDMENT | 2016-08-08 | COUGHLAN & MURRAY FAMILY PRACTICE, PA | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2020-01-13 |
| ANNUAL REPORT | 2019-06-13 |
| ANNUAL REPORT | 2018-06-25 |
| ANNUAL REPORT | 2017-08-22 |
| Amendment and Name Change | 2017-02-06 |
| Name Change | 2016-08-08 |
| ANNUAL REPORT | 2016-02-16 |
| ANNUAL REPORT | 2015-01-22 |
| Domestic Profit | 2014-01-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
