| Entity Name: | SPACE COAST NEPHROLOGY ASSOCIATES, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
SPACE COAST NEPHROLOGY ASSOCIATES, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 29 Nov 2018 (6 years ago) |
| Document Number: | L18000275354 |
| FEI/EIN Number |
832685821
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 111 E. HIBISCUS BLVD., MELBOURNE, FL, 32901, US |
| Mail Address: | 111 E. HIBISCUS BLVD., MELBOURNE, FL, 32901, US |
| ZIP code: | 32901 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821552696 | 2019-01-25 | 2021-08-02 | 111 E HIBISCUS BLVD, MELBOURNE, FL, 329013102, US | 111 E HIBISCUS BLVD, MELBOURNE, FL, 329013102, US | |||||||||||||||
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| Phone | +1 321-768-3655 |
| Fax | 3218313024 |
Authorized person
| Name | TABITHA ABRAHAM |
| Role | PRACTICE ADMINISTRATOR |
| Phone | 3217683655 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SPACE COAST NEPHROLOGY ASSOCIATES, PLLC 401(K) | 2021 | 832685821 | 2022-06-15 | SPACE COAST NEPHROLOGY ASSOCIATES, PLLC | 33 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2022-06-15 |
| Name of individual signing | TABITHA ABRAHAM |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-06-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 3217683655 |
| Plan sponsor’s address | 109 SILVER PALM AVE, MELBOURNE, FL, 32901 |
Signature of
| Role | Plan administrator |
| Date | 2022-09-14 |
| Name of individual signing | TABITHA ABRAHAM |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-06-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 3217683655 |
| Plan sponsor’s address | 109 SILVER PALM AVE, MELBOURNE, FL, 32901 |
Signature of
| Role | Plan administrator |
| Date | 2021-06-01 |
| Name of individual signing | TABITHA ABRAHAM |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-06-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 3217683655 |
| Plan sponsor’s address | 109 SILVER PALM AVE, MELBOURNE, FL, 32901 |
Signature of
| Role | Plan administrator |
| Date | 2020-06-16 |
| Name of individual signing | TABITHA ABRAHAM |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| AHMED TAMER M.D. | Manager | 111 E. HIBISCUS BLVD., MELBOURNE, FL, 32901 |
| PATEL VISHNU M.D. | Manager | 111 E. HIBISCUS BLVD., MELBOURNE, FL, 32901 |
| SPIES CLAUS PM.D. | Manager | 111 E. HIBISCUS BLVD., MELBOURNE, FL, 32901 |
| PATEL VISHNU | Agent | 111 E. HIBISCUS BLVD., MELBOURNE, FL, 32901 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-03-30 | PATEL, VISHNU | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-30 | 111 E. HIBISCUS BLVD., MELBOURNE, FL 32901 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-11 | 111 E. HIBISCUS BLVD., MELBOURNE, FL 32901 | - |
| CHANGE OF MAILING ADDRESS | 2020-05-11 | 111 E. HIBISCUS BLVD., MELBOURNE, FL 32901 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-30 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-03-23 |
| ANNUAL REPORT | 2021-02-16 |
| ANNUAL REPORT | 2020-03-23 |
| ANNUAL REPORT | 2019-03-27 |
| Florida Limited Liability | 2018-11-29 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1602687110 | 2020-04-10 | 0455 | PPP | 111 E Hisbiscus Blvd, Melbourne, FL, 32901 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Mar 2025
Sources: Florida Department of State
