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  5. BREVARD HEALTH CARE LLC

BREVARD HEALTH CARE LLC

Company Details

Entity Name: BREVARD HEALTH CARE LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 29 May 2003 (22 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 05 Jun 2003 (22 years ago)
Document Number: L03000019303
FEI/EIN Number 320078898
Address: 1735 W Hisbiscus Blvd, SUITE 201, MELBOURNE, FL, 32901, US
Mail Address: 1735 W Hisbiscus Blvd, SUITE 201, MELBOURNE, FL, 32901, US
ZIP code: 32901
County: Brevard
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1427271345 2007-04-10 2010-04-22 240 N WICKHAM RD, SUITE 202, MELBOURNE, FL, 329358662, US 240 N WICKHAM RD, SUITE 202, MELBOURNE, FL, 329358662, US

Contacts
Phone +1 321-259-5999
Fax 3212595553

Authorized person
Name MRS. BRANDY J MARCZUK
Role OFFICE MANAGER
Phone 3212595999

Taxonomy
Taxonomy Code 207R00000X - Internal Medicine Physician
License Number ME81535
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BREVARD HEALTH CARE, LLC 401(K) P/S PLAN 2019 320078898 2020-09-17 BREVARD HEALTH CARE, LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3212596178
Plan sponsor’s address 240 N WICKHAM ROAD, SUITE 202, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2020-09-17
Name of individual signing MARISSA ROCOURT
Valid signature Filed with authorized/valid electronic signature
BREVARD HEALTH CARE, LLC 401(K) P/S PLAN 2018 320078898 2019-10-04 BREVARD HEALTH CARE, LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3212596178
Plan sponsor’s address 240 N WICKHAM ROAD, SUITE 202, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2019-10-04
Name of individual signing MARISSA ROCOURT
Valid signature Filed with authorized/valid electronic signature
BREVARD HEALTH CARE, LLC 401(K) P/S PLAN 2017 320078898 2018-07-30 BREVARD HEALTH CARE, LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3212596178
Plan sponsor’s address 240 N WICKHAM ROAD, SUITE 202, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2018-07-30
Name of individual signing MARISSA ROCOURT
Valid signature Filed with authorized/valid electronic signature
BREVARD HEALTH CARE, LLC 401(K) P/S PLAN 2016 320078898 2017-08-04 BREVARD HEALTH CARE, LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3212596178
Plan sponsor’s address 240 N WICKHAM ROAD, SUITE 202, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2017-08-04
Name of individual signing MARISSA ROCOURT
Valid signature Filed with authorized/valid electronic signature
BREVARD HEALTH CARE, LLC 401(K) P/S PLAN 2015 320078898 2016-08-17 BREVARD HEALTH CARE, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3212596178
Plan sponsor’s address 240 N WICKHAM ROAD, SUITE 202, MELBOURNE, FL, 32935
BREVARD HEALTH CARE, LLC 401(K) P/S PLAN 2014 320078898 2015-07-18 BREVARD HEALTH CARE, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3212596178
Plan sponsor’s address 240 N WICKHAM ROAD, SUITE 202, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2015-07-18
Name of individual signing MARISSA ROCOURT
Valid signature Filed with authorized/valid electronic signature
BREVARD HEALTH CARE, LLC 401(K) P/S PLAN 2013 320078898 2014-09-02 BREVARD HEALTH CARE, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3212596178
Plan sponsor’s address 240 N WICKHAM ROAD, SUITE 202, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2014-09-02
Name of individual signing MARISSA ROCOURT
Valid signature Filed with authorized/valid electronic signature
BREVARD HEALTH CARE, LLC 401(K) P/S PLAN 2012 320078898 2013-04-04 BREVARD HEALTH CARE, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3212596178
Plan sponsor’s address 240 N WICKHAM ROAD, SUITE 202, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2013-04-04
Name of individual signing MARISSA ROCOURT
Valid signature Filed with authorized/valid electronic signature
BREVARD HEALTH CARE, LLC 401(K) P/S PLAN 2011 320078898 2012-04-10 BREVARD HEALTH CARE, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3212596178
Plan sponsor’s address 240 N WICKHAM ROAD, SUITE 202, MELBOURNE, FL, 32935

Plan administrator’s name and address
Administrator’s EIN 320078898
Plan administrator’s name BREVARD HEALTH CARE, LLC
Plan administrator’s address 240 N WICKHAM ROAD, SUITE 202, MELBOURNE, FL, 32935
Administrator’s telephone number 3212596178

Signature of
Role Plan administrator
Date 2012-04-10
Name of individual signing MARISSA ROCOURT
Valid signature Filed with authorized/valid electronic signature
BREVARD HEALTH CARE, LLC 401(K) P/S PLAN 2010 320078898 2011-05-24 BREVARD HEALTH CARE, LLC 3
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3212596178
Plan sponsor’s address 240 N WICKHAM ROAD, SUITE 202, MELBOURNE, FL, 32935

Plan administrator’s name and address
Administrator’s EIN 320078898
Plan administrator’s name BREVARD HEALTH CARE, LLC
Plan administrator’s address 240 N WICKHAM ROAD, SUITE 202, MELBOURNE, FL, 32935
Administrator’s telephone number 3212596178

Signature of
Role Plan administrator
Date 2011-05-24
Name of individual signing MICHAEL GEMMELL
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name Role Address
MARISSA ROCOURT Agent 1735 W Hisbiscus Blvd, MELBOURNE, FL, 32901

Manager

Name Role Address
ROCOURT MARISSA D Manager 1735 W Hisbiscus Blvd, MELBOURNE, FL, 32901

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2014-03-28 1735 W Hisbiscus Blvd, SUITE 201, MELBOURNE, FL 32901 No data
CHANGE OF MAILING ADDRESS 2014-03-28 1735 W Hisbiscus Blvd, SUITE 201, MELBOURNE, FL 32901 No data
REGISTERED AGENT ADDRESS CHANGED 2014-03-28 1735 W Hisbiscus Blvd, SUITE 201, MELBOURNE, FL 32901 No data
REGISTERED AGENT NAME CHANGED 2012-04-20 MARISSA, ROCOURT No data
NAME CHANGE AMENDMENT 2003-06-05 BREVARD HEALTH CARE LLC No data

Documents

Name Date
ANNUAL REPORT 2024-01-28
ANNUAL REPORT 2023-03-12
ANNUAL REPORT 2022-02-21
ANNUAL REPORT 2021-02-07
ANNUAL REPORT 2020-02-01
ANNUAL REPORT 2019-03-17
ANNUAL REPORT 2018-04-07
ANNUAL REPORT 2017-05-02
ANNUAL REPORT 2016-04-05
ANNUAL REPORT 2015-03-18

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
7744207708 2020-05-01 0455 PPP 1735 W HIBISCUS BLVD, MELBOURNE, FL, 32901-2608
Loan Status Date 2021-08-11
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 46100
Loan Approval Amount (current) 46100
Undisbursed Amount 0
Franchise Name -
Lender Location ID 44449
Servicing Lender Name PNC Bank, National Association
Servicing Lender Address 222 Delaware Ave, WILMINGTON, DE, 19801-1621
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Unanswered
Project Address MELBOURNE, BREVARD, FL, 32901-2608
Project Congressional District FL-08
Number of Employees 5
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 44449
Originating Lender Name PNC Bank, National Association
Originating Lender Address WILMINGTON, DE
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 46662.16
Forgiveness Paid Date 2021-07-21

Related by officers

No related officers

Related by address

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Date of last update: 01 Feb 2025

Sources: Florida Department of State

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