| Entity Name: | KALEIDOSCOPE INTERVENTIONS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Oct 2014 (10 years ago) |
| Document Number: | L14000155838 |
| FEI/EIN Number | 47-2066133 |
| Mail Address: | 125 East Nasa Blvd, Melbourne, FL, 32901, US |
| Address: | 125 East Nasa Blvd, MELBOURNE, FL, 32901, US |
| ZIP code: | 32901 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902200116 | 2014-10-17 | 2020-10-08 | 125 E NASA BLVD STE 104, MELBOURNE, FL, 329011900, US | 5830 US HIGHWAY 1 STE 104, ROCKLEDGE, FL, 329555704, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 321-265-4429 |
| Fax | 3217656434 |
| Phone | +1 321-609-9007 |
Authorized person
| Name | PAMELA FURR |
| Role | CEO AND MANAGING MEMBER |
| Phone | 3213726813 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | UNITED HEALTHCARE |
| Number | GRP2008 |
| Issuer | MEDICAID |
| Number | 014022600 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHEILD |
| Number | 0089A |
| Issuer | CIGNA |
| Number | 4642140 |
| Issuer | AETNA |
| Number | 4953527 |
| Issuer | CIGNA |
| Number | 5670969 |
| Issuer | CIGNA |
| Number | 5670970 |
| Issuer | FLORIDA BLUE |
| Number | GF43S |
| Issuer | MEDICAID |
| Number | 017449700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FURR PAMELA | Agent | 125 East Nasa Blvd, Melbourne, FL, 32901 |
| Name | Role | Address |
|---|---|---|
| FURR PAMELA | Manager | 125 East Nasa Blvd, Melbourne, FL, 32901 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-01-13 | 125 East Nasa Blvd, MELBOURNE, FL 32901 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-13 | 125 East Nasa Blvd, Melbourne, FL 32901 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-11 | 125 East Nasa Blvd, MELBOURNE, FL 32901 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-02-05 |
| ANNUAL REPORT | 2022-03-28 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-22 |
| ANNUAL REPORT | 2019-03-11 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-01-13 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-04-06 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
