| Entity Name: | COASTAL PULMONARY AND SLEEP CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Dec 2021 (3 years ago) |
| Document Number: | L21000534748 |
| FEI/EIN Number | 87-4753384 |
| Address: | 140 SIXTH AVE, INDIALANTIC, FL, 32903, US |
| Mail Address: | 140 SIXTH AVE, INDIALANTIC, FL, 32903, US |
| ZIP code: | 32903 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013664390 | 2022-03-07 | 2022-03-07 | 140 6TH AVE, INDIALANTIC, FL, 329033204, US | 140 6TH AVE, INDIALANTIC, FL, 329033204, US | |||||||||||||
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| Phone | +1 321-312-3501 |
Authorized person
| Name | PRAKASH V REDDY |
| Role | PHYSICIAN |
| Phone | 3213123501 |
Taxonomy
| Taxonomy Code | 207RS0012X - Sleep Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| REDDY ANJANA | Agent | 140 SIXTH AVE, INDIALANTIC, FL, 32903 |
| Name | Role | Address |
|---|---|---|
| REDDY ANJANA | Manager | 8145 SOUTH TROPICAL TRAIL, MERRITT ISLAND, FL, 32952 |
| Name | Role | Address |
|---|---|---|
| REDDY PRAKASH | Authorized Member | 8145 SOUTH TROPICAL TRAIL, MERRITT ISLAND, FL, 32952 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-22 | 140 SIXTH AVE, INDIALANTIC, FL 32903 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-22 | 140 SIXTH AVE, INDIALANTIC, FL 32903 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-22 | 140 SIXTH AVE, INDIALANTIC, FL 32903 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-25 |
| ANNUAL REPORT | 2023-01-24 |
| AMENDED ANNUAL REPORT | 2022-04-22 |
| ANNUAL REPORT | 2022-01-30 |
| Florida Limited Liability | 2021-12-21 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
