| Entity Name: | COASTAL CARE MEDICAL SUPPLY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 09 Nov 1998 (26 years ago) |
| Date of dissolution: | 11 Aug 2011 (13 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 11 Aug 2011 (13 years ago) |
| Document Number: | P98000094703 |
| FEI/EIN Number | 650874208 |
| Address: | 1440 RAIL HEAD BLVD, 7, NAPLES, FL, 34110, US |
| Mail Address: | 1800 W WOOLBRIGHT ROAD, 200, BOYNTON BEACH, FL, 33426, US |
| ZIP code: | 34110 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356651673 | 2010-10-20 | 2010-10-20 | 1800 W WOOLBRIGHT RD, 200, BOYNTON BEACH, FL, 334266398, US | 755 NW 17TH AVE, 105, DELRAY BEACH, FL, 334452522, US | |||||||||||||||||||||||||||||
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| Phone | +1 561-819-0460 |
| Fax | 5612077781 |
| Phone | +1 561-265-4310 |
| Fax | 5612144004 |
Authorized person
| Name | MR. JONATHAN JAMES FEDELE |
| Role | PRESIDENT |
| Phone | 5612654310 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 1887 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA |
| Number | 1887 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FEDELE JONATHAN J | Agent | 701 SW 36 AVENUE, BOYNTON BEACH, FL, 33435 |
| Name | Role | Address |
|---|---|---|
| FEDELE JONATHAN J | President | 701 SW 36 AVENUE, BOYNTON BEACH, FL, 33435 |
| Name | Role | Address |
|---|---|---|
| MIKO KYLE W | Vice President | 5716 NW 125 TERRACE, CORAL SPRINGS, FL, 33076 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000079181 | HME PARTNERS | EXPIRED | 2010-08-27 | 2015-12-31 | No data | 1800 W. WOOLBRIGHT ROAD, SUITE 200, BOYNTON BEACH, FL, 33426 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2011-08-11 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-01-12 | 1440 RAIL HEAD BLVD, 7, NAPLES, FL 34110 | No data |
| CHANGE OF MAILING ADDRESS | 2011-01-12 | 1440 RAIL HEAD BLVD, 7, NAPLES, FL 34110 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-03-17 | 701 SW 36 AVENUE, BOYNTON BEACH, FL 33435 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2011-08-11 |
| ANNUAL REPORT | 2011-01-12 |
| ANNUAL REPORT | 2010-01-07 |
| ANNUAL REPORT | 2009-07-29 |
| ANNUAL REPORT | 2009-02-16 |
| ANNUAL REPORT | 2008-04-22 |
| ANNUAL REPORT | 2007-01-08 |
| ANNUAL REPORT | 2006-03-14 |
| ANNUAL REPORT | 2005-01-03 |
| ANNUAL REPORT | 2004-03-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
