| Entity Name: | COASTAL CARDIOLOGY PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 05 Nov 2015 (9 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | P15000091112 |
| Address: | 1508 STURBRIDGE COURT, DUNEDIN, FL, 34698 |
| Mail Address: | 1508 STURBRIDGE COURT, DUNEDIN, FL, 34698 |
| ZIP code: | 34698 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730553546 | 2015-11-17 | 2015-11-17 | 1508 STURBRIDGE CT, DUNEDIN, FL, 346982260, US | 1508 STURBRIDGE CT, DUNEDIN, FL, 346982260, US | |||||||||||||||||||||||
|
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| Phone | +1 727-484-1166 |
Authorized person
| Name | DR. A- HAMID I HAKKI |
| Role | OWNER |
| Phone | 7274241166 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| License Number | ME50357 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 047848200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HAKKI A. HAMID IMD | Agent | 1508 STURBRIDGE COURT, DUNEDIN, FL, 34698 |
| Name | Role | Address |
|---|---|---|
| HAKKI A HAMID IMD | President | 1508 STURBRIDGE COURT, DUNEDIN, FL, 34698 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2015-11-05 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
