| Entity Name: | STACIA POOLE, MD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 26 Jun 2015 (10 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L15000109615 |
| FEI/EIN Number | 47-4380044 |
| Address: | 6351 Portofino Lane, Melbourne, FL, 32940, US |
| Mail Address: | 6351 Portofino Lane, Melbourne, FL, 32940, US |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467837476 | 2015-07-21 | 2015-07-21 | 930 S HARBOR CITY BLVD, SUITE 101, MELBOURNE, FL, 329011963, US | 930 S HARBOR CITY BLVD, SUITE 101, MELBOURNE, FL, 329011963, US | |||||||||||||||||
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| Phone | +1 321-917-8472 |
Authorized person
| Name | DR. STACIA POOLE |
| Role | OWNER |
| Phone | 3219178472 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| License Number | ME51873 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FRESE GARY B | Agent | 2200 FRONT STREET, MELBOURNE, FL, 32901 |
| Name | Role | Address |
|---|---|---|
| POOLE STACIA | Manager | PO Box 360915, Melbourne, FL, 32936 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-29 | 6351 Portofino Lane, Melbourne, FL 32940 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-29 | 6351 Portofino Lane, Melbourne, FL 32940 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-03-18 | 2200 FRONT STREET, MELBOURNE, FL 32901 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-01-12 |
| ANNUAL REPORT | 2019-03-02 |
| ANNUAL REPORT | 2018-01-30 |
| ANNUAL REPORT | 2017-02-12 |
| ANNUAL REPORT | 2016-03-18 |
| Florida Limited Liability | 2015-06-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
