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SPACE COAST MEDICINE LLC - Florida Company Profile

Company Details

Entity Name: SPACE COAST MEDICINE LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

SPACE COAST MEDICINE LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 22 Jul 2022 (3 years ago)
Document Number: L22000325079
FEI/EIN Number 88-4156528

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 310 AVENUE A, MELBOURNE BEACH, FL, 32951, UN
Mail Address: 310 AVENUE A, MELBOURNE BEACH, FL, 32951, UN
ZIP code: 32951
County: Brevard
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1245931419 2023-03-15 2023-03-15 PO BOX 510195, MELBOURNE BEACH, FL, 329510195, US 310 AVENUE A, MELBOURNE BEACH, FL, 329512201, US

Contacts

Phone +1 850-544-0142

Authorized person

Name ANTHONY HERZOG
Role MD
Phone 8505440142

Taxonomy

Taxonomy Code 207R00000X - Internal Medicine Physician
Is Primary Yes

Key Officers & Management

Name Role Address
HERZOG STEPHANIE Manager 310 AVENUE A, MELBOURNE BEACH, FL, 32951
HERZOG ANTHONY Agent 310 AVENUE A, MELBOURNE BEACH, FL, 32951

Documents

Name Date
ANNUAL REPORT 2024-02-21
ANNUAL REPORT 2023-02-02
Florida Limited Liability 2022-07-22

Date of last update: 03 Mar 2025

Sources: Florida Department of State