| Entity Name: | GRIFFITH UROLOGY, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Jan 2023 (2 years ago) |
| Document Number: | L23000031081 |
| FEI/EIN Number | 92-1920445 |
| Address: | 575 S. Wickham Road, West Melbourne, FL, 32904, US |
| Mail Address: | 575 S. Wickham Road, West Melbourne, FL, 32904, US |
| ZIP code: | 32904 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306545751 | 2023-02-24 | 2023-02-24 | 575 S WICKHAM RD STE A, MELBOURNE, FL, 329041170, US | 575 S WICKHAM RD STE A, MELBOURNE, FL, 329041170, US | |||||||||||||||
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| Phone | +1 321-727-8940 |
| Fax | 3217337050 |
Authorized person
| Name | BRIAN C GRIFFITH |
| Role | OWNER |
| Phone | 3217278940 |
Taxonomy
| Taxonomy Code | 208800000X - Urology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ANDERSON PATRICK J | Agent | 2200 FRONT STREET, SUITE 301, MELBOURNE, FL, 32901 |
| Name | Role | Address |
|---|---|---|
| BRIAN CHACE GRIFFITH, M.D. | Manager | 575 S. Wickham Road, West Melbourne, FL, 32904 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-30 | 575 S. Wickham Road, Suite A, West Melbourne, FL 32904 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-30 | 575 S. Wickham Road, Suite A, West Melbourne, FL 32904 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-30 |
| Florida Limited Liability | 2023-01-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
