| Entity Name: | SCO EYE SURGERY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Jun 2024 (7 months ago) |
| Document Number: | L24000282594 |
| Address: | 1832 GARDEN ST., TITUSVILLE, FL, 32796, US |
| Mail Address: | 1832 GARDEN ST., TITUSVILLE, FL, 32796, US |
| ZIP code: | 32796 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669218285 | 2024-07-03 | 2024-08-14 | 1832 GARDEN ST, TITUSVILLE, FL, 327963200, US | 1832 GARDEN ST, TITUSVILLE, FL, 327963200, US | |||||||||||||||||
|
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| Phone | +1 321-267-0008 |
Authorized person
| Name | NICHOLAS PEFKAROS |
| Role | MEDICAL DIRECTOR |
| Phone | 3212670008 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QS0132X - Ophthalmologic Surgery Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| THALWITZER AARON ESQ. | Agent | 299 N. ORLANDO AVE., COCOA BEACH, FL, 32931 |
| Name | Role |
|---|---|
| SPACE COAST OPHTHALMOLOGY LLC | Authorized Member |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-06-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
