| Entity Name: | SYMPHONY SPECIALTY GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 May 2022 (3 years ago) |
| Document Number: | L22000211229 |
| FEI/EIN Number | 88-2438064 |
| Address: | 8613 old kings Rd South, JACKSONVILLE, FL, 32217, US |
| Mail Address: | 8613 old kings road, JACKSONVILLE, FL, 32217, US |
| ZIP code: | 32217 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831878735 | 2023-07-17 | 2023-07-17 | 8613 OLD KINGS RD S STE 602, JACKSONVILLE, FL, 322174863, US | 8613 OLD KINGS RD S STE 602, JACKSONVILLE, FL, 322174863, US | |||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 904-493-3390 |
| Fax | 9044933395 |
Authorized person
| Name | ANDREW ESCAMILLA |
| Role | CEO |
| Phone | 9044933390 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| Is Primary | No |
| Taxonomy Code | 163WP0000X - Pain Management Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 163WW0000X - Wound Care Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | No |
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | No |
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| KEVIN CRISMOND, D.O. | Agent | 8613 Old Kings Road South, JACKSONVILLE, FL, 32217 |
| Name | Role |
|---|---|
| JACKSONVILLE HOSPITALISTS, P.A. | Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-09 | 8613 old kings Rd South, Suite 602, JACKSONVILLE, FL 32217 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-09 | 8613 old kings Rd South, Suite 602, JACKSONVILLE, FL 32217 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-09 | 8613 Old Kings Road South, #602, JACKSONVILLE, FL 32217 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-02-09 |
| Florida Limited Liability | 2022-05-18 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
