| Entity Name: | SPACE COAST MEDICAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
SPACE COAST MEDICAL, 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: | 01 Aug 2011 (14 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 27 Mar 2024 (a year ago) |
| Document Number: | L11000088035 |
| FEI/EIN Number |
453716351
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 2069 MOBILAND DR., MELBOURNE, FL, 32935, US |
| Mail Address: | 2069 MOBILAND DR., MELBOURNE, FL, 32935, US |
| ZIP code: | 32935 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376807511 | 2012-07-03 | 2015-07-28 | 4295 N US HIGHWAY 1, MELBOURNE, FL, 329354822, US | 935 BAREFOOT BLVD, BLDG 1 SUITE 2, BAREFOOT BAY, FL, 329767620, US | |||||||||||||||||||||||||
|
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| Phone | +1 321-557-4667 |
Authorized person
| Name | JASON LAIL |
| Role | C.E.O. |
| Phone | 3215574667 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | OS6898 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QR0400X - Rehabilitation Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LAIL JASON | Manager | 2069 MOBILAND DR., MELBOURNE, FL, 32935 |
| YANCEY GINA L | Officer | 585 ORANGE GROVE AVE., MELBOURNE, FL, 32904 |
| YANCEY GINA L | Manager | 585 ORANGE GROVE AVE., MELBOURNE, FL, 32904 |
| YANCEY GINA | Agent | 2069 MOBILAND DR., MELBOURNE, FL, 32935 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000009132 | SPACE COAST MEDICAL CONSULTING | EXPIRED | 2017-01-25 | 2022-12-31 | - | 4295 N. US HWY 1, MELBOURNE, FL, 32935 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-27 | 2069 MOBILAND DR., MELBOURNE, FL 32935 | - |
| LC AMENDMENT | 2024-03-27 | - | - |
| REGISTERED AGENT NAME CHANGED | 2024-03-27 | YANCEY, GINA | - |
| LC AMENDMENT | 2024-03-19 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-19 | 2069 MOBILAND DR., MELBOURNE, FL 32935 | - |
| CHANGE OF MAILING ADDRESS | 2024-03-19 | 2069 MOBILAND DR., MELBOURNE, FL 32935 | - |
| LC AMENDMENT | 2022-12-22 | - | - |
| REINSTATEMENT | 2015-09-28 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | - | - |
| Name | Date |
|---|---|
| LC Amendment | 2024-03-27 |
| LC Amendment | 2024-03-19 |
| ANNUAL REPORT | 2024-02-29 |
| ANNUAL REPORT | 2023-02-27 |
| LC Amendment | 2022-12-22 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-01-15 |
| ANNUAL REPORT | 2020-03-03 |
| ANNUAL REPORT | 2019-01-17 |
| ANNUAL REPORT | 2018-03-05 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
