| Entity Name: | SANTROCK PSYCHIATRY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Feb 2013 (12 years ago) |
| Document Number: | L13000016812 |
| FEI/EIN Number | 46-2038976 |
| Address: | 2089 S. Ridgewood Ave., South Daytona, FL, 32119, US |
| Mail Address: | P.O. BOX 731572, ORMOND BEACH, FL, 32173, US |
| ZIP code: | 32119 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811315104 | 2014-04-03 | 2023-11-07 | 2089 S RIDGEWOOD AVE STE B, SOUTH DAYTONA, FL, 321192240, US | 2089 S RIDGEWOOD AVE STE B, SOUTH DAYTONA, FL, 321192240, US | |||||||||||||||||||
|
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| Phone | +1 386-957-3905 |
| Fax | 3864921131 |
Authorized person
| Name | SALVADOR CEVALLOS |
| Role | OWNER |
| Phone | 3869573905 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME101696 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FAVILA-CEVALLOS MONICA | Agent | 2089 S. Ridgewood Ave., South Daytona, FL, 32119 |
| Name | Role | Address |
|---|---|---|
| CEVALLOS SALVADOR LEO | Managing Member | P.O. BOX 731572, ORMOND BEACH, FL, 32173 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000089262 | STILLPOINT PSYCHIATRY | ACTIVE | 2023-07-31 | 2028-12-31 | No data | 208 BLACK HICKORY WAY, ORMOND BEACH, FL, 32174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-20 | 2089 S. Ridgewood Ave., Suite B, South Daytona, FL 32119 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-20 | 2089 S. Ridgewood Ave., Suite B, South Daytona, FL 32119 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-20 |
| ANNUAL REPORT | 2023-01-15 |
| ANNUAL REPORT | 2022-01-22 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-01-19 |
| ANNUAL REPORT | 2019-03-09 |
| ANNUAL REPORT | 2018-02-05 |
| ANNUAL REPORT | 2017-02-01 |
| ANNUAL REPORT | 2016-02-07 |
| ANNUAL REPORT | 2015-02-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
