| Entity Name: | GEORGIA DAVIS, M.D. AND ASSOCIATES L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 May 2016 (9 years ago) |
| Last Event: | LC AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 13 Jun 2016 (9 years ago) |
| Document Number: | L16000100083 |
| FEI/EIN Number | 30-0589567 |
| Address: | 1331 Bedford Drive, Melbourne, FL, 32940, US |
| Mail Address: | GEORGIA DAVIS, M.D. AND ASSOCIATES L.L.C., 1112 RICKARD RD., SPRINGFIELD, IL, 62704, US |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285937060 | 2010-12-16 | 2016-07-26 | 1112 RICKARD RD, SUITE B, SPRINGFIELD, IL, 627041017, US | 1331 BEDFORD DR, SUITE 101, MELBOURNE, FL, 329401987, US | |||||||||||||||||||||||
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| Phone | +1 217-787-9540 |
| Fax | 2177879183 |
| Phone | +1 321-622-8114 |
| Fax | 3216224649 |
Authorized person
| Name | MR. CHARLES JOSEPH MERTZ |
| Role | BUSINESS MANAGER |
| Phone | 2177879540 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | 0036078693 |
| State | IL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DAVIS GEORGIA A | Agent | 1245 SILVER LAKE DR, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| MERTZ CHARLES J | Busi | GEORGIA DAVIS, M.D. AND ASSOCIATES L.L.C., SPRINGFIELD, IL, 62704 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-08 | 1245 SILVER LAKE DR, MELBOURNE, FL 32940 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-18 | 1331 Bedford Drive, Suite 101, Melbourne, FL 32940 | No data |
| LC AMENDMENT AND NAME CHANGE | 2016-06-13 | GEORGIA DAVIS, M.D. AND ASSOCIATES L.L.C. | No data |
| CHANGE OF MAILING ADDRESS | 2016-06-13 | 1331 Bedford Drive, Suite 101, Melbourne, FL 32940 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-02 |
| ANNUAL REPORT | 2024-01-03 |
| ANNUAL REPORT | 2023-03-08 |
| ANNUAL REPORT | 2022-03-31 |
| ANNUAL REPORT | 2021-02-11 |
| ANNUAL REPORT | 2020-03-18 |
| ANNUAL REPORT | 2019-01-16 |
| ANNUAL REPORT | 2018-03-08 |
| ANNUAL REPORT | 2017-01-09 |
| LC Amendment and Name Change | 2016-06-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
