| Entity Name: | COASTAL MEDICAL INTEGRATION, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 Nov 2020 (4 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 14 Apr 2022 (3 years ago) |
| Document Number: | P20000092398 |
| FEI/EIN Number | 85-4190768 |
| Address: | 3481 GULF BREEZE PARKWAY, GULF BREEZE, FL, 32563 |
| Mail Address: | 3481 GULF BREEZE PARKWAY, GULF BREEZE, FL, 32563 |
| ZIP code: | 32563 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326638818 | 2021-01-19 | 2022-11-21 | 3481 GULF BREEZE PKWY, GULF BREEZE, FL, 325631402, US | 3481 GULF BREEZE PKWY, GULF BREEZE, FL, 325631402, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 850-903-1708 |
Authorized person
| Name | SHEILA DECKER |
| Role | OWNER |
| Phone | 8509031383 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DECKER SHEILA SDC | Agent | 3481 GULF BREEZE PARKWAY, GULF BREEZE, FL, 32563 |
| Name | Role | Address |
|---|---|---|
| DECKER SHEILA SDC | President | 3481 GULF BREEZE PARKWAY, GULF BREEZE, FL, 32563 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000119918 | COASTAL MEDICAL INTEGRATION | KNEE, BACK & JOINT PAIN CLINIC | ACTIVE | 2022-09-22 | 2027-12-31 | No data | 3481 GULFF BREEZE PKWY., GULF BREEZE, FL, 32563 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-04-14 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-04-14 | DECKER, SHEILA S, DC | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-21 |
| ANNUAL REPORT | 2023-03-31 |
| REINSTATEMENT | 2022-04-14 |
| Domestic Profit | 2020-11-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
