| Entity Name: | CONSTELLATION SUPPORT SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Oct 2022 (2 years ago) |
| Document Number: | L22000464023 |
| FEI/EIN Number | 920853987 |
| Address: | 5726 Old Cheney Hwy, Orlando, FL, 32807, US |
| Mail Address: | 5726 Old Cheney Hwy, Orlando, FL, 32807, US |
| ZIP code: | 32807 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205549078 | 2022-12-26 | 2023-11-06 | 7726 WINEGARD RD STE 53, ORLANDO, FL, 328097147, US | 7726 WINEGARD RD STE 53, ORLANDO, FL, 328097147, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 407-900-5278 |
Authorized person
| Name | CORALIS CALDERON |
| Role | OWNER |
| Phone | 4079025919 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 114731200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CALDERON MARTINEZ CORALIS | Agent | 5726 Old Cheney Hwy, Orlando, FL, 32807 |
| Name | Role | Address |
|---|---|---|
| CALDERON MARTINEZ CORALIS | Manager | 5726 OLD CHENEY HWY, ORLANDO, 32807 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-10-01 | 5726 Old Cheney Hwy, Orlando, FL 32807 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-09-16 | 5726 Old Cheney Hwy, Orlando, FL 32807 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-09-16 | 5726 Old Cheney Hwy, Orlando, FL 32807 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-09-16 |
| ANNUAL REPORT | 2024-04-14 |
| ANNUAL REPORT | 2023-03-22 |
| Florida Limited Liability | 2022-10-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
