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FAMILY PRACTICE ON THE GO OF FLORIDA, INC. - Florida Company Profile

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Company Details

Entity Name: FAMILY PRACTICE ON THE GO OF FLORIDA, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 04 Dec 2017 (8 years ago)
Document Number: P17000095885
FEI/EIN Number 82-3705847
Address: 735 Dunlawton Ave, Port Orange, FL, 32127, US
Mail Address: 735 Dunlawton Ave, Port Orange, FL, 32127, US
ZIP code: 32127
City: Port Orange
County: Volusia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
HEISE DAVID Manager 735 Dunlawton Ave, Port Orange, FL, 32127
HEISE DAVID Agent 735 Dunlawton Ave, Port Orange, FL, 32127

National Provider Identifier

NPI Number:
1184132888
Certification Date:
2024-10-15

Authorized Person:

Name:
DR. DAVID HEISE
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3868724232

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-02-04 735 Dunlawton Ave, Port Orange, FL 32127 -
CHANGE OF MAILING ADDRESS 2024-02-04 735 Dunlawton Ave, Port Orange, FL 32127 -
REGISTERED AGENT ADDRESS CHANGED 2024-02-04 735 Dunlawton Ave, Port Orange, FL 32127 -

Documents

Name Date
ANNUAL REPORT 2025-02-10
ANNUAL REPORT 2024-02-04
AMENDED ANNUAL REPORT 2023-04-27
ANNUAL REPORT 2023-02-15
ANNUAL REPORT 2022-01-27
ANNUAL REPORT 2021-04-16
ANNUAL REPORT 2020-02-02
ANNUAL REPORT 2019-02-10
Domestic Profit 2017-12-04

USAspending Awards / Financial Assistance

Date:
2021-03-29
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
170085.00
Total Face Value Of Loan:
170085.00
Date:
2020-05-03
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
170085.00
Total Face Value Of Loan:
170085.00
Date:
2020-05-03
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
170085.00
Total Face Value Of Loan:
170085.00

Paycheck Protection Program

Jobs Reported:
16
Initial Approval Amount:
$170,085
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$170,085
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$171,907.01
Servicing Lender:
Cross River Bank
Use of Proceeds:
Payroll: $170,085
Jobs Reported:
13
Initial Approval Amount:
$170,085
Date Approved:
2021-03-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$170,085
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$171,823.13
Servicing Lender:
Seacoast National Bank
Use of Proceeds:
Payroll: $170,082
Utilities: $1

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Date of last update: 02 Aug 2025

Sources: Florida Department of State