| Entity Name: | FAIRBANKS PARTNERS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Jun 2015 (10 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 18 Aug 2015 (9 years ago) |
| Document Number: | L15000113503 |
| FEI/EIN Number | 47-4412267 |
| Address: | 265 E Rollins Street, Orlando, FL, 32804, US |
| Mail Address: | 265 E Rollins Street, Orlando, FL, 32804, US |
| ZIP code: | 32804 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457735326 | 2015-07-10 | 2024-02-06 | 265 E ROLLINS ST STE 12000, ORLANDO, FL, 328045571, US | 265 E ROLLINS ST STE 12000, ORLANDO, FL, 328045571, US | |||||||||||||||||||||
|
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| Phone | +1 407-975-0200 |
| Fax | 4079750209 |
Authorized person
| Name | MELVIN FIELD |
| Role | PRESIDENT |
| Phone | 4079750200 |
Taxonomy
| Taxonomy Code | 207T00000X - Neurological Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 015390400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Goins Sara M | Agent | 265 E Rollins Street, Orlando, FL, 32804 |
| Name | Role | Address |
|---|---|---|
| BAKER CHRISTOPHER DR. | Manager | 265 E Rollins Street, Orlando, FL, 32804 |
| GARG ANKUR DR. | Manager | 265 E Rollins Street, Orlando, FL, 32804 |
| FIELD MELVIN DR. | Manager | 265 E Rollins Street, Orlando, FL, 32804 |
| HELLINGER FRANK DR. | Manager | 265 E Rollins Street, Orlando, FL, 32804 |
| ROSEN DAVID DR. | Manager | 265 E Rollins Street, Orlando, FL, 32804 |
| BELLEW MICHAEL DR | Manager | 265 E Rollins Street, Orlando, FL, 32804 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000131273 | ORLANDO NEUROSURGERY | ACTIVE | 2016-12-07 | 2027-12-31 | No data | 1605 WEST FAIRBANKS AVENUE, WINTER PARK, FL, 32789 |
| G15000071187 | ORLANDO NEUROSURGERY, PA | EXPIRED | 2015-07-08 | 2020-12-31 | No data | 1605 WEST FAIRBANKS AVENUE, WINTER PARK, FL, 32789 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-30 | 265 E Rollins Street, Suite 12000, Orlando, FL 32804 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-12-07 | 265 E Rollins Street, SUITE 12000, Orlando, FL 32804 | No data |
| CHANGE OF MAILING ADDRESS | 2022-12-07 | 265 E Rollins Street, SUITE 12000, Orlando, FL 32804 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-01-31 | Goins, Sara M | No data |
| LC AMENDMENT | 2015-08-18 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-01-29 |
| ANNUAL REPORT | 2018-01-18 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-03-03 |
| LC Amendment | 2015-08-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
