| Entity Name: | PALM BEACH GENERAL SURGERY AND HERNIA CENTER, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 30 May 2017 (8 years ago) |
| Document Number: | L17000117830 |
| FEI/EIN Number | 82-1679389 |
| Address: | 3370 BURNS ROAD, SUITE 100, PALM BEACH GARDENS, FL 33410 |
| Mail Address: | Palm Beach General Surgery and Hernia Center, 3370 Burns Road, Suite #100, Palm Beach Gardens, FL 33410 |
| ZIP code: | 33410 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063933505 | 2017-07-06 | 2022-07-21 | 3370 BURNS RD STE 100, PALM BEACH GARDENS, FL, 334104327, US | 3370 BURNS RD STE 100, PALM BEACH GARDENS, FL, 334104327, US | |||||||||||||||||
|
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| Phone | +1 864-546-0353 |
Authorized person
| Name | DAVID COYKENDALL |
| Role | OWNER |
| Phone | 8645460353 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | OS11700 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Coykendall, Virginia | Agent | 3370 Burns Road, Suite #100, Palm Beach Gardens, FL 33410 |
| Name | Role | Address |
|---|---|---|
| COYKENDALL, DAVID S, D.O. | Manager | 3370 Burns Road, Suite #100 Palm Beach Gardens, FL 33410 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000094581 | SEASIDE HERNIA CENTER | ACTIVE | 2021-07-20 | 2026-12-31 | No data | 3370 BURNS ROAD, SUITE 100, NORTH PALM BEACH, FL, 33408 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2018-04-26 | 3370 BURNS ROAD, SUITE 100, PALM BEACH GARDENS, FL 33410 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-04-26 | Coykendall, Virginia | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-26 | 3370 Burns Road, Suite #100, Palm Beach Gardens, FL 33410 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-06-08 | 3370 BURNS ROAD, SUITE 100, PALM BEACH GARDENS, FL 33410 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-05-23 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-06-25 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-04-26 |
| Florida Limited Liability | 2017-05-30 |
Date of last update: 18 Feb 2025
Sources: Florida Department of State
