| Entity Name: | LCB PHYSICIANS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Nov 2019 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 25 Nov 2019 (5 years ago) |
| Document Number: | L19000275434 |
| FEI/EIN Number | 84-3642995 |
| Address: | 410 PALMETTO ST, NEW SMYRNA BEACH, FL, 32168, US |
| Mail Address: | 1648 TAYLOR ROAD, #606, PORT ORANGE, FL, 32128, US |
| ZIP code: | 32168 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275163461 | 2020-01-16 | 2020-03-01 | 1648 TAYLOR RD # 606, PORT ORANGE, FL, 321286753, US | 410 PALMETTO ST, NEW SMYRNA BEACH, FL, 321687323, US | |||||||||||||||||
|
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| Phone | +1 813-313-8013 |
| Fax | 3867032304 |
| Phone | +1 386-267-6224 |
Authorized person
| Name | LOUIS CHARLES BLAUM III |
| Role | OWNER |
| Phone | 8133138013 |
Taxonomy
| Taxonomy Code | 2086S0105X - Surgery of the Hand (Surgery) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BLAUM LOUIS CIII | Agent | 6078 SHALLOW BROOK CT, PORT ORANGE, FL, 32128 |
| Name | Role | Address |
|---|---|---|
| BLAUM LOUIS CIII | Manager | 6078 SHALLOW BROOK CT, PORT ORANGE, FL, 32128 |
| Name | Role | Address |
|---|---|---|
| BLAUM LINDSAY M | Authorized Representative | 6078 SHALLOW BROOK CT, PORT ORANGE, FL, 32128 |
| Name | Role | Address |
|---|---|---|
| BLAUM LOUIS CIII | Authorized Member | 6078 SHALLOW BROOK CT, PORT ORANGE, FL, 32128 |
| Name | Role | Address |
|---|---|---|
| BLAUM LOUIS CIII | President | 6078 SHALLOW BROOK CT, PORT ORANGE, FL, 32128 |
| Name | Role | Address |
|---|---|---|
| BLAUM LOUIS CIII | Managing Member | 6078 SHALLOW BROOK CT, PORT ORANGE, FL, 32128 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000136774 | BLAUM HAND CLINIC | ACTIVE | 2019-12-27 | 2029-12-31 | No data | 1648 TAYLOR RD, #606, PORT ORANGE, FL, 32128 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2019-11-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-11-25 | 410 PALMETTO ST, NEW SMYRNA BEACH, FL 32168 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-24 |
| ANNUAL REPORT | 2023-02-23 |
| ANNUAL REPORT | 2022-03-27 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-06-07 |
| LC Amendment | 2019-11-25 |
| Florida Limited Liability | 2019-11-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
