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OCEANWAY MEDICAL CENTER, INC.

Company Details

Entity Name: OCEANWAY MEDICAL CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 02 Nov 1999 (25 years ago)
Document Number: P99000096192
FEI/EIN Number 593606613
Address: 11513 NORTH MAIN STREET, JACKSONVILLE, FL, 32218-4002, US
Mail Address: 11513 NORTH MAIN STREET, JACKSONVILLE, FL, 32218-4002, US
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1245255199 2006-07-13 2022-07-21 11513 N MAIN ST, JACKSONVILLE, FL, 322184002, US 11513 N MAIN ST, JACKSONVILLE, FL, 322184002, US

Contacts
Phone +1 904-751-6200
Fax 9047511600

Authorized person
Name JEANNE MICOLUCCI
Role PRESIDENT
Phone 9047516200

Taxonomy
Taxonomy Code 207Q00000X - Family Medicine Physician
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 257848400
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
OCEANWAY MEDICAL CENTER INC. 401(K) PROFIT SHARING PLAN AND TRUST 2014 593606613 2015-09-14 OCEANWAY MEDICAL CENTER INC. 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 9047516200
Plan sponsor’s address 11513 N. MAIN STREET, JACKSONVILLE, FL, 32218
OCEANWAY MEDICAL CENTER INC. 401(K) PROFIT SHARING PLAN AND TRUST 2013 593606613 2014-08-07 OCEANWAY MEDICAL CENTER INC. 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 9047516200
Plan sponsor’s address 11513 N. MAIN STREET, JACKSONVILLE, FL, 32218
OCEANWAY MEDICAL CENTER INC 401 K PROFIT SHARING PLAN TRUST 2012 593606613 2013-06-12 OCEANWAY MEDICAL CENTER INC 31
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 9047516200
Plan sponsor’s address 11513 N MAIN ST, JACKSONVILLE, FL, 32218

Signature of
Role Plan administrator
Date 2013-06-12
Name of individual signing OCEANWAY MEDICAL CENTER INC
Valid signature Filed with authorized/valid electronic signature
OCEANWAY MEDICAL CENTER INC 401 K PROFIT SHARING PLAN TRUST 2011 593606613 2012-05-08 OCEANWAY MEDICAL CENTER INC 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 9047516200
Plan sponsor’s address 11513 N MAIN ST, JACKSONVILLE, FL, 32218

Plan administrator’s name and address
Administrator’s EIN 593606613
Plan administrator’s name OCEANWAY MEDICAL CENTER INC
Plan administrator’s address 11513 N MAIN ST, JACKSONVILLE, FL, 32218
Administrator’s telephone number 9047516200

Signature of
Role Plan administrator
Date 2012-05-08
Name of individual signing OCEANWAY MEDICAL CENTER INC
Valid signature Filed with authorized/valid electronic signature
OCEANWAY MEDICAL CENTER INC 401 K PROFIT SHARING PLAN TRUST 2010 593606613 2011-07-06 OCEANWAY MEDICAL CENTER INC 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 9047516200
Plan sponsor’s address 11513 NORTH MAIN STREET, JACKSONVILLE, FL, 322184002

Plan administrator’s name and address
Administrator’s EIN 593606613
Plan administrator’s name OCEANWAY MEDICAL CENTER INC
Plan administrator’s address 11513 NORTH MAIN STREET, JACKSONVILLE, FL, 322184002
Administrator’s telephone number 9047516200

Signature of
Role Plan administrator
Date 2011-07-06
Name of individual signing OCEANWAY MEDICAL CENTER INC
Valid signature Filed with authorized/valid electronic signature
OCEANWAY MEDICAL CENTER INC 2009 593606613 2010-06-25 OCEANWAY MEDICAL CENTER INC 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 9047516200
Plan sponsor’s address 11513 NORTH MAIN STREET, JACKSONVILLE, FL, 322184002

Plan administrator’s name and address
Administrator’s EIN 593606613
Plan administrator’s name OCEANWAY MEDICAL CENTER INC
Plan administrator’s address 11513 NORTH MAIN STREET, JACKSONVILLE, FL, 322184002
Administrator’s telephone number 9047516200

Signature of
Role Plan administrator
Date 2010-06-25
Name of individual signing OCEANWAY MEDICAL CENTER INC
Valid signature Filed with authorized/valid electronic signature
OCEANWAY MEDICAL CENTER INC 2009 593606613 2010-06-25 OCEANWAY MEDICAL CENTER INC 29
Three-digit plan number (PN) 002
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 9047516200
Plan sponsor’s address 11513 NORTH MAIN STREET, JACKSONVILLE, FL, 322184002

Plan administrator’s name and address
Administrator’s EIN 593606613
Plan administrator’s name OCEANWAY MEDICAL CENTER INC
Plan administrator’s address 11513 NORTH MAIN STREET, JACKSONVILLE, FL, 322184002
Administrator’s telephone number 9047516200

Signature of
Role Plan administrator
Date 2010-06-25
Name of individual signing OCEANWAY MEDICAL CENTER INC
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name Role Address
Micolucci Victor L Agent 1707 Strand Street, Neptune Beach, FL, 32266

President

Name Role Address
MICOLUCCI JEANNE B President 904 ORIENTAL GARDENS, JACKSONVILLE, FL, 32207

Vice President

Name Role Address
MICOLUCCI VICTOR C Vice President 904 ORIENTAL GARDENS, JACKSONVILLE, FL, 32207

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2022-02-07 Micolucci, Victor L No data
REGISTERED AGENT ADDRESS CHANGED 2022-02-07 1707 Strand Street, Neptune Beach, FL 32266 No data
CHANGE OF PRINCIPAL ADDRESS 2012-02-08 11513 NORTH MAIN STREET, JACKSONVILLE, FL 32218-4002 No data
CHANGE OF MAILING ADDRESS 2012-02-08 11513 NORTH MAIN STREET, JACKSONVILLE, FL 32218-4002 No data

Documents

Name Date
ANNUAL REPORT 2024-03-14
ANNUAL REPORT 2023-02-21
ANNUAL REPORT 2022-02-07
ANNUAL REPORT 2021-02-05
ANNUAL REPORT 2020-03-19
ANNUAL REPORT 2019-04-09
ANNUAL REPORT 2018-01-15
ANNUAL REPORT 2017-02-02
ANNUAL REPORT 2016-03-14
ANNUAL REPORT 2015-01-28

Related by officers

MICOLUCCI JEANNE B

MICOLUCCI CREATIVE LLC MICOLUCCI ENTERPRISES, INC.

MICOLUCCI VICTOR C

OCEANWAY FAMILY PRACTICE CENTER, INC.

Micolucci Victor L

MICOLUCCI ENTERPRISES, INC.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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