| Entity Name: | BRIAN HAMZAVI, MD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Nov 2020 (4 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 14 Sep 2023 (a year ago) |
| Document Number: | L20000349952 |
| FEI/EIN Number | 85-3772628 |
| Address: | 1091 Port Malabar Boulevard NE, Palm Bay, FL, 32905, US |
| Mail Address: | 3440 POSEIDON WAY, MELBOURNE, FL, 32903, US |
| ZIP code: | 32905 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275308660 | 2023-11-16 | 2023-11-16 | 3440 POSEIDON WAY, INDIALANTIC, FL, 329031840, US | 1091 PORT MALABAR BLVD NE STE 2, PALM BAY, FL, 329055100, US | |||||||||||||
|
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| Phone | +1 267-481-0901 |
Authorized person
| Name | DR. BRIAN HAMZAVI |
| Role | OWNER / ORTHOPAEDIC SURGEON |
| Phone | 2674810901 |
Taxonomy
| Taxonomy Code | 163WX0800X - Orthopedic Registered Nurse |
| Is Primary | Yes |
| Name | Role |
|---|---|
| BRIAN HAMZAVI, MD, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| HAMZAVI BRIAN MD | Manager | 3440 POSEIDON WAY, MELBOURNE, FL, 32903 |
| Name | Role | Address |
|---|---|---|
| HAMZAVI TAMMY PA-C | Authorized Member | 3440 POSEIDON WAY, MELBOURNE, FL, 32903 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000146976 | HAMMER ORTHOPAEDICS & SPORTS MEDICINE | ACTIVE | 2020-11-16 | 2025-12-31 | No data | 3440 POSEIDON WAY, MELBOURNE, FL, 32903 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-16 | 1091 Port Malabar Boulevard NE, Suite 2, Palm Bay, FL 32905 | No data |
| REINSTATEMENT | 2023-09-14 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-09-14 | 3440 POSEIDON WAY, MELBOURNE, FL 32903 | No data |
| CHANGE OF MAILING ADDRESS | 2023-09-14 | 1091 Port Malabar Boulevard NE, Suite 2, Palm Bay, FL 32905 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-12-05 | Brian Hamzavi MD, LLC | No data |
| REINSTATEMENT | 2021-12-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-16 |
| REINSTATEMENT | 2023-09-14 |
| REINSTATEMENT | 2021-12-05 |
| Florida Limited Liability | 2020-11-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
