Entity Name: | PEDIATRIC ENT, LLC |
Jurisdiction: | FLORIDA |
Filing Type: |
Florida Limited Liability Co.
PEDIATRIC ENT, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
Date Filed: | 17 Nov 2008 (16 years ago) |
Last Event: | LC AMENDED/RESTATED ARTICLE/NAME CHANGE |
Event Date Filed: | 14 Feb 2012 (13 years ago) |
Document Number: | L08000106611 |
FEI/EIN Number |
263957831
Federal Employer Identification (FEI) Number assigned by the IRS. |
Address: | 1499 S. HARBOUR CITY BLVD, SUITE 303, MELBOURNE, FL, 32901 |
Mail Address: | 1499 S. HARBOUR CITY BLVD, SUITE 303, MELBOURNE, FL, 32901 |
ZIP code: | 32901 |
County: | Brevard |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1508002072 | 2009-01-05 | 2014-04-18 | 1499 S HARBOR CITY BLVD STE 303, MELBOURNE, FL, 329013245, US | 1499 S HARBOR CITY BLVD STE 303, MELBOURNE, FL, 329013245, US | |||||||||||||||||||||||||||||||||||||||||||
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Phone | +1 321-254-5437 |
Fax | 3212544543 |
Authorized person
Name | DR. DAVID JOEL MALIS |
Role | MANAGER |
Phone | 3212545437 |
Taxonomy
Taxonomy Code | 207YP0228X - Pediatric Otolaryngology Physician |
License Number | ME90348 |
State | FL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID HMO - AMERIGROUP |
Number | 01269821 |
State | FL |
Issuer | MEDICAID HMO - UNITED HEALTH CARE |
Number | 2258392 |
State | FL |
Issuer | MEDICAID HMO - WELLCARE |
Number | 332181 |
State | FL |
Issuer | MEDICAID |
Number | 271247400 |
State | FL |
Name | Role | Address |
---|---|---|
MALIS DAVID J | Manager | 290 LANSING ISLAND DR, SATELLITE BEACH, FL, 32937 |
Malis Cheryl L | Vice President | 1499 S. HARBOUR CITY BLVD, MELBOURNE, FL, 32901 |
NASH CHARLES IAN | Agent | C/O NASH & KROMASH, LLP, MELBOURNE, FL, 32901 |
Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
---|---|---|---|---|---|---|
G21000164939 | FAMILY ENT & AUDIOLOGY | ACTIVE | 2021-12-13 | 2026-12-31 | - | 1499 S HARBOR CITY BLVD STE 303, MELBOURNE, FL, 32901 |
G12000113090 | FAMILY ENT & AUDIOLOGY | EXPIRED | 2012-11-26 | 2017-12-31 | - | 1499 S HARBOR CITY BLVD, SUITE 303, MELBOURNE, FL, 32901 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
LC AMENDED AND RESTATED ARTICLES | 2012-02-14 | - | - |
LC AMENDED/RESTATED ARTICLE/NAME CHANGE | 2012-02-14 | PEDIATRIC ENT, LLC | - |
REGISTERED AGENT NAME CHANGED | 2012-02-14 | NASH, CHARLES IAN | - |
REGISTERED AGENT ADDRESS CHANGED | 2012-02-14 | C/O NASH & KROMASH, LLP, 440 SOUTH BABCOCK STREET, MELBOURNE, FL 32901 | - |
CHANGE OF PRINCIPAL ADDRESS | 2010-02-16 | 1499 S. HARBOUR CITY BLVD, SUITE 303, MELBOURNE, FL 32901 | - |
CHANGE OF MAILING ADDRESS | 2010-02-16 | 1499 S. HARBOUR CITY BLVD, SUITE 303, MELBOURNE, FL 32901 | - |
Name | Date |
---|---|
ANNUAL REPORT | 2025-02-23 |
ANNUAL REPORT | 2024-01-07 |
ANNUAL REPORT | 2023-01-22 |
ANNUAL REPORT | 2022-02-10 |
AMENDED ANNUAL REPORT | 2021-03-23 |
ANNUAL REPORT | 2021-01-25 |
ANNUAL REPORT | 2020-02-01 |
ANNUAL REPORT | 2019-01-15 |
ANNUAL REPORT | 2018-01-14 |
ANNUAL REPORT | 2017-02-22 |
Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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9514917005 | 2020-04-09 | 0455 | PPP | 1499 S Harbor City Blvd, Melbourne, FL, 32901-3210 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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2116718308 | 2021-01-20 | 0455 | PPS | 1499 S Harbor City Blvd Ste 303, Melbourne, FL, 32901-3245 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Mar 2025
Sources: Florida Department of State