| Entity Name: | GULF COAST HEALTH CARE SERVICES INCORPORATED |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 09 Sep 1992 (32 years ago) |
| Date of dissolution: | 27 Jul 2015 (10 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 27 Jul 2015 (10 years ago) |
| Document Number: | V62833 |
| FEI/EIN Number | 65-0348924 |
| Address: | 1646 S. ORANGE AVENUE, SARASOTA, FL 34239 |
| Mail Address: | 1646 S. ORANGE AVENUE, SARASOTA, FL 34239 |
| ZIP code: | 34239 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356355358 | 2006-07-28 | 2014-01-21 | 1646 S ORANGE AVE, SARASOTA, FL, 342392036, US | 153 CENTER RD, VENICE, FL, 342855572, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 941-343-3033 |
| Fax | 9419548725 |
| Phone | +1 941-408-8988 |
| Fax | 9414088846 |
Authorized person
| Name | MR. DONALD CRAIG BRIMM |
| Role | PRESIDENT |
| Phone | 9413433033 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY6161 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW10105 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME97864 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME58216 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2084P0802X - Addiction Psychiatry Physician |
| License Number | ME97864 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2084P0805X - Geriatric Psychiatry Physician |
| License Number | ME58216 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| License Number | ARNP9276826 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| License Number | ARNP9295470 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002809900 |
| State | FL |
| Issuer | MEDICAID |
| Number | 002809901 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BRIMM, D. CRAIG | Agent | 1646 S. ORANGE AVENUE, SARASOTA, FL 34239 |
| Name | Role | Address |
|---|---|---|
| BRIMM, D. CRAIG | President | 1646 S. ORANGE AVENUE, SARASOTA, FL 34239 |
| Name | Role | Address |
|---|---|---|
| BRIMM, D. CRAIG | Secretary | 1646 S. ORANGE AVENUE, SARASOTA, FL 34239 |
| Name | Role | Address |
|---|---|---|
| BRIMM, D. CRAIG | Treasurer | 1646 S. ORANGE AVENUE, SARASOTA, FL 34239 |
| Name | Role | Address |
|---|---|---|
| BRIMM, D. CRAIG | Director | 1646 S. ORANGE AVENUE, SARASOTA, FL 34239 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-07-27 | No data | No data |
| AMENDMENT | 2010-02-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-01-31 | 1646 S. ORANGE AVENUE, SARASOTA, FL 34239 | No data |
| CHANGE OF MAILING ADDRESS | 2010-01-31 | 1646 S. ORANGE AVENUE, SARASOTA, FL 34239 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-01-31 | BRIMM, D. CRAIG | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-01-31 | 1646 S. ORANGE AVENUE, SARASOTA, FL 34239 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2015-07-27 |
| ANNUAL REPORT | 2015-03-25 |
| ANNUAL REPORT | 2014-01-13 |
| AMENDED ANNUAL REPORT | 2013-12-17 |
| ANNUAL REPORT | 2013-02-14 |
| ANNUAL REPORT | 2012-01-17 |
| ANNUAL REPORT | 2011-01-06 |
| Amendment | 2010-02-26 |
| ANNUAL REPORT | 2010-01-31 |
| ANNUAL REPORT | 2009-04-22 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
