Detail by Officer/Registered Agent Name

Florida Not For Profit Corporation

FIRST COAST INDEPENDENT PRACTICE ASSOCIATION, INC.

Filing Information
N14000003889 N/A 04/21/2014 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 09/23/2022 NONE
Principal Address
3901 UNIVERSITY BLVD
Suite #221
JACKSONVILLE, FL 32216

Changed: 02/16/2021
Mailing Address
3901 UNIVERSITY BLVD
Suite #221
JACKSONVILLE, FL 32216

Changed: 02/16/2021
Registered Agent Name & Address NEEDHAM, JAMES DARRELL
3901 UNIVERSITY BLVD
Suite #221
JACKSONVILLE, FL 32216

Name Changed: 02/21/2020

Address Changed: 02/16/2021
Officer/Director Detail Name & Address

Title CEO

NEEDHAM, JAMES DARRELL
3901 UNIVERSITY BLVD
SUITE #221
JACKSONVILLE, FL 32216

Title P

HAYES, KEVIN
3901 UNIVERSITY BLVD
SUITE #221
JACKSONVILLE, FL 32216

Title Member

Pubbi, Dinesh
3901 UNIVERSITY BLVD
SUITE #221
JACKSONVILLE, FL 32216

Annual Reports
Report YearFiled Date
2019 02/27/2019
2020 02/21/2020
2021 02/16/2021