| Entity Name: | DAMASK PHYSICIANS GROUP, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Jul 2007 (18 years ago) |
| Document Number: | L07000078054 |
| FEI/EIN Number | 260674935 |
| Address: | 795 PRIMERA BLVD., 1031, LAKE MARY, FL, 32746 |
| Mail Address: | PO BOX 954117, LAKE MARY, FL, 32795 |
| ZIP code: | 32746 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023283967 | 2008-04-22 | 2020-04-17 | 795 PRIMERA BLVD, SUITE 1031, LAKE MARY, FL, 327462191, US | 795 PRIMERA BLVD, SUITE 1031, LAKE MARY, FL, 327462191, US | |||||||||||||||||||||||||
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| Phone | +1 407-829-8981 |
| Fax | 4079421049 |
Authorized person
| Name | CECELIA DAMASK |
| Role | PHYSICIAN |
| Phone | 4078298981 |
Taxonomy
| Taxonomy Code | 207Y00000X - Otolaryngology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207YX0602X - Otolaryngic Allergy Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS |
| Number | FD6869861 |
| State | NC |
| Name | Role | Address |
|---|---|---|
| Damask Cecelia CDr. | Agent | 954117 West Lake Mary Blvd, LAKE MARY, FL, 32795 |
| Name | Role | Address |
|---|---|---|
| DAMASK CECELIA D | Manager | 795 PRIMERA BLVD, STE. 1031, LAKE MARY, FL, 32746 |
| Name | Role | Address |
|---|---|---|
| Blanton Kimberly | Admi | 954117 west lake Mary blvd, LAKE MARY, FL, 32795 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G07330700077 | LAKE MARY EAR, NOSE, THROAT, & ALLERGY | ACTIVE | 2007-11-26 | 2028-12-31 | No data | PO BOX 954117, LAKE MARY, FL, 32795 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-30 | 954117 West Lake Mary Blvd, LAKE MARY, FL 32795 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-04-29 | Damask, Cecelia C, Dr. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-03-25 | 795 PRIMERA BLVD., 1031, LAKE MARY, FL 32746 | No data |
| CHANGE OF MAILING ADDRESS | 2008-01-09 | 795 PRIMERA BLVD., 1031, LAKE MARY, FL 32746 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-29 |
| ANNUAL REPORT | 2016-03-23 |
| ANNUAL REPORT | 2015-04-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
