| Entity Name: | CARE SPINE AND SPORTS HEALTH, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Jan 2023 (2 years ago) |
| Document Number: | L23000009530 |
| FEI/EIN Number | 92-1655183 |
| Address: | 629 HUMMINGBIRD DR, INDIALANTIC, FL, 32903, US |
| Mail Address: | 629 HUMMINGBIRD DR, INDIALANTIC, FL, 32903, US |
| ZIP code: | 32903 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245945328 | 2023-01-23 | 2023-01-23 | 629 HUMMINGBIRD DR, INDIALANTIC, FL, 329034772, US | 2795 W NEW HAVEN AVE, WEST MELBOURNE, FL, 329043705, US | |||||||||||||||||
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| Phone | +1 440-465-9363 |
| Phone | +1 321-622-8626 |
| Fax | 8008139164 |
Authorized person
| Name | HART MEYRICH |
| Role | BUSINESS MANAGER |
| Phone | 4073409039 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SOUFFRANT JEAN GUY YOMA | Agent | 629 HUMMINGBIRD DR, INDIALANTIC, FL, 32903 |
| Name | Role | Address |
|---|---|---|
| SOUFFRANT JEAN GUY- YOMA | Authorized Member | 629 HUMMINGBIRD DR, INDIALANTIC, FL, 32903 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| Florida Limited Liability | 2023-01-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
