| Entity Name: | CCM SPECIALISTS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 08 Dec 2014 (10 years ago) |
| Date of dissolution: | 22 Sep 2019 (5 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 22 Sep 2019 (5 years ago) |
| Document Number: | L14000186997 |
| FEI/EIN Number | 47-2502506 |
| Address: | 8515 abingdon ct, Duluth, GA 30097 |
| Mail Address: | 8515 Abingdon ct, Duluth, GA 30097 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891183984 | 2014-12-26 | 2014-12-26 | 1108 AMBER LAKE CT, CAPE CORAL, FL, 33909, US | 1108 AMBER LAKE CT, CAPE CORAL, FL, 33909, US | |||||||||||||||||
|
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| Phone | +1 425-270-5432 |
Authorized person
| Name | DR. AJAY K DHAWAN |
| Role | MEDICAL DIRECTOR |
| Phone | 2396995830 |
Taxonomy
| Taxonomy Code | 171M00000X - Case Manager/Care Coordinator |
| License Number | ME105093 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DHAWAN, AJAY | Agent | 1108 AMBER LAKE CT, CAPE CORAL, FL 33909 |
| Name | Role | Address |
|---|---|---|
| DHAWAN, AJAY | Chief Executive Officer | 8515 Abingdon ct, Duluth, GA 30097 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2019-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-01-20 | 8515 abingdon ct, Duluth, GA 30097 | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-18 | 8515 abingdon ct, Duluth, GA 30097 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2019-09-22 |
| ANNUAL REPORT | 2019-01-20 |
| ANNUAL REPORT | 2018-01-21 |
| ANNUAL REPORT | 2017-03-18 |
| ANNUAL REPORT | 2016-06-09 |
| ANNUAL REPORT | 2015-01-10 |
| Florida Limited Liability | 2014-12-08 |
Date of last update: 21 Jan 2025
Sources: Florida Department of State
