| Entity Name: | SPARK MEDICAL SUPPLY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 28 Mar 2019 (6 years ago) |
| Date of dissolution: | 23 Jun 2021 (4 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 23 Jun 2021 (4 years ago) |
| Document Number: | L19000085848 |
| FEI/EIN Number | 83-4193731 |
| Address: | 3175 S CONGRESS AVE, SUITE 305-D, PALM SPRINGS, FL 33461 |
| Mail Address: | 3175 S CONGRESS AVE, SUITE 305-D, PALM SPRINGS, FL 33461 |
| ZIP code: | 33461 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083274112 | 2019-06-20 | 2020-03-12 | 3175 S CONGRESS AVE STE 305D, PALM SPRINGS, FL, 334612562, US | 3175 S CONGRESS AVE STE 305D, PALM SPRINGS, FL, 334612562, US | |||||||||||||
|
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| Phone | +1 561-469-7980 |
Authorized person
| Name | MICHAEL NUSSBAUM |
| Role | OWNER |
| Phone | 5614697980 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KING, COLTON | Agent | 5722 LAKE GEORGE PL, LAKE WORTH, FL 33463 |
| Name | Role | Address |
|---|---|---|
| NUSSBAUM, MICHAEL S | Manager | 5201 VAN BUREN RD, DELRAY BEACH, FL 33484 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2021-06-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-12-06 | 3175 S CONGRESS AVE, SUITE 305-D, PALM SPRINGS, FL 33461 | No data |
| CHANGE OF MAILING ADDRESS | 2019-12-06 | 3175 S CONGRESS AVE, SUITE 305-D, PALM SPRINGS, FL 33461 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2021-06-23 |
| ANNUAL REPORT | 2020-06-08 |
| Florida Limited Liability | 2019-03-28 |
Date of last update: 17 Jan 2025
Sources: Florida Department of State
