| Entity Name: | SPACE COAST SURGERY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 May 2008 (17 years ago) |
| Document Number: | L08000053963 |
| FEI/EIN Number | 262716202 |
| Address: | 3629 imperata drive, rockledge, FL, 32955, US |
| Mail Address: | 3629 imperata drive, rockledge, FL, 32955, US |
| ZIP code: | 32955 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760622526 | 2009-03-05 | 2014-08-26 | 8255 N WICKHAM RD, SUITE 102, MELBOURNE, FL, 329408202, US | 8255 N WICKHAM RD, SUITE 102, MELBOURNE, FL, 329408202, US | |||||||||||||||||||
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| Phone | +1 321-242-7060 |
| Fax | 3212426050 |
Authorized person
| Name | DR. CHINMAY S. MAJMUNDAR |
| Role | PHYSCIAN/OWNER |
| Phone | 3212427060 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | ME 96869 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MAJMUNDAR CHINMAY M | Agent | 3629 IMPERATA DR, ROCKLEDGE, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| MAJMUNDAR CHINMAY | Manager | 3629 IMPERATA DR, ROCKLEDGE, FL, 32955 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-03-10 | 3629 imperata drive, rockledge, FL 32955 | No data |
| CHANGE OF MAILING ADDRESS | 2019-03-10 | 3629 imperata drive, rockledge, FL 32955 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-01-16 | MAJMUNDAR, CHINMAY MD | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-07 |
| ANNUAL REPORT | 2020-03-21 |
| ANNUAL REPORT | 2019-03-10 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
