| Entity Name: | SURGICAL PHYSICIAN ASSISTANTS, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Oct 2005 (19 years ago) |
| Document Number: | L05000100842 |
| FEI/EIN Number | 203614533 |
| Address: | 205 PLATT AVE, MERRITT ISLAND, FL, 32952, US |
| Mail Address: | P.O. BOX 362, COCOA, FL, 32923, US |
| ZIP code: | 32952 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467560896 | 2006-08-27 | 2010-12-08 | PO BOX 362, COCOA, FL, 329230362, US | 205 PLATT AVE, MERRITT ISLAND, FL, 329524963, US | |||||||||||||||||||||||||
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| Phone | +1 321-615-4800 |
| Fax | 3215740590 |
Authorized person
| Name | MR. BRIAN MICHAEL JANKE |
| Role | OWNER |
| Phone | 3216154800 |
Taxonomy
| Taxonomy Code | 363AS0400X - Surgical Physician Assistant |
| License Number | PA 9102122 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE GROUP ID # |
| Number | K9613 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JANKE BRIAN M | Agent | 205 PLATT AVE, MERRITT ISLAND, FL, 32952 |
| Name | Role | Address |
|---|---|---|
| JANKE BRIAN M | Manager | 205 PLATT AVE, MERRITT ISLAND, FL, 32952 |
| Name | Role | Address |
|---|---|---|
| JANKE PAUL R | Managing Member | 2400 STERLING CREEK PARKWAY, OVIEDO, FL, 32766 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2009-01-15 | 205 PLATT AVE, MERRITT ISLAND, FL 32952 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-01-15 | 205 PLATT AVE, MERRITT ISLAND, FL 32952 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-19 |
| ANNUAL REPORT | 2023-02-27 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-02-02 |
| ANNUAL REPORT | 2020-01-22 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-02-01 |
| ANNUAL REPORT | 2017-02-20 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-03-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
