| Entity Name: | GASTROENTEROLOGY CARE SPECIALISTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Sep 2019 (5 years ago) |
| Document Number: | L19000233529 |
| FEI/EIN Number | 843099690 |
| Address: | 150 E Redstone Avenue, CRESTVIEW, FL, 32539, US |
| Mail Address: | 150 E Redstone Avenue, CRESTVIEW, FL, 32539, US |
| ZIP code: | 32539 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750922399 | 2019-10-04 | 2019-10-04 | 550 REDSTONE AVE W STE 430, CRESTVIEW, FL, 325366457, US | 550 REDSTONE AVE W STE 430, CRESTVIEW, FL, 325366457, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 850-398-8605 |
Authorized person
| Name | DR. KHALID MOUSSA |
| Role | DR |
| Phone | 2254055441 |
Taxonomy
| Taxonomy Code | 207RG0100X - Gastroenterology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MOUSSA KHALID M | Agent | 150 E Redstone Avenue, CRESTVIEW, FL, 32539 |
| Name | Role | Address |
|---|---|---|
| MOUSSA KHALID M | Authorized Member | 150 E Redstone Avenue, CRESTVIEW, FL, 32539 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-24 | 150 E Redstone Avenue, Suite B, CRESTVIEW, FL 32539 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-24 | 150 E Redstone Avenue, Suite B, CRESTVIEW, FL 32539 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-24 | 150 E Redstone Avenue, Suite B, CRESTVIEW, FL 32539 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-03-24 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-04-27 |
| Florida Limited Liability | 2019-09-16 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
