| Entity Name: | FT. LAUDERDALE FIRST ASSIST, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 25 Jan 2008 (17 years ago) |
| Date of dissolution: | 08 Mar 2016 (9 years ago) |
| Last Event: | LC WITHDRAWAL |
| Event Date Filed: | 08 Mar 2016 (9 years ago) |
| Document Number: | M08000000426 |
| FEI/EIN Number | 35-2321973 |
| Address: | 1600 Sarno Road, Suite 15, Melbourne, FL 32935 |
| Mail Address: | ATTN: Legal, 3100 West End Ave., Suite 800, NASHVILLE, TN 37203 |
| ZIP code: | 32935 |
| County: | Brevard |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811175052 | 2008-02-08 | 2014-12-05 | 214 CENTERVIEW DRIVE, SUITE 100, BRENTWOOD, TN, 37027, US | 1600 SARNO ROAD, SUITE 15, MELBOURNE, FL, 32935, US | |||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 615-345-5450 |
| Fax | 6153455365 |
| Phone | +1 800-348-4565 |
| Fax | 3216105115 |
Authorized person
| Name | MR. JEFFREY T GRAY |
| Role | CFO & TREASURER |
| Phone | 6153455550 |
Taxonomy
| Taxonomy Code | 363AS0400X - Surgical Physician Assistant |
| License Number | PA 3649 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363AS0400X - Surgical Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 364SM0705X - Medical-Surgical Clinical Nurse Specialist |
| License Number | RN 3003202 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 364SM0705X - Medical-Surgical Clinical Nurse Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001019600 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATE CREATIONS NETWORK INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Hall , Melvin F. | Chairman | 3100 WEST END AVENUE, SUITE 800, NASHVILLE, TN 37203 |
| Name | Role | Address |
|---|---|---|
| Hall , Melvin F. | Chief Executive Officer | 3100 WEST END AVENUE, SUITE 800, NASHVILLE, TN 37203 |
| Name | Role | Address |
|---|---|---|
| Hall , Melvin F. | President | 3100 WEST END AVENUE, SUITE 800, NASHVILLE, TN 37203 |
| Name | Role | Address |
|---|---|---|
| Hall , Melvin F. | Manager | 3100 WEST END AVENUE, SUITE 800, NASHVILLE, TN 37203 |
| Elliott , William J. | Manager | 3100 WEST END AVENUE, SUITE 800, NASHVILLE, TN 37203 |
| Gray, Jeffrey T. | Manager | 3100 WEST END AVENUE, SUITE 800, NASHVILLE, TN 37203 |
| Name | Role | Address |
|---|---|---|
| Elliott , William J. | Vice President | 3100 WEST END AVENUE, SUITE 800, NASHVILLE, TN 37203 |
| Name | Role | Address |
|---|---|---|
| Gray, Jeffrey T. | Chief Financial Officer | 3100 WEST END AVENUE, SUITE 800, NASHVILLE, TN 37203 |
| Name | Role | Address |
|---|---|---|
| Gray, Jeffrey T. | Treasurer | 3100 WEST END AVENUE, SUITE 800, NASHVILLE, TN 37203 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC WITHDRAWAL | 2016-03-08 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-03-23 | 1600 Sarno Road, Suite 15, Melbourne, FL 32935 | No data |
| CHANGE OF MAILING ADDRESS | 2015-03-23 | 1600 Sarno Road, Suite 15, Melbourne, FL 32935 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-02-02 | CORPORATE CREATIONS NETWORK, INC. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-02-02 | 11380 PROSPERITY FARMS ROAD #221E, PALM BEACH GARDENS, FL 33410 | No data |
| Name | Date |
|---|---|
| LC Withdrawal | 2016-03-08 |
| ANNUAL REPORT | 2015-03-23 |
| ANNUAL REPORT | 2014-03-06 |
| ANNUAL REPORT | 2013-04-12 |
| ANNUAL REPORT | 2012-04-24 |
| ANNUAL REPORT | 2011-04-21 |
| ANNUAL REPORT | 2010-04-05 |
| Reg. Agent Change | 2010-02-02 |
| ANNUAL REPORT | 2009-03-24 |
| Foreign Limited | 2008-01-25 |
Date of last update: 26 Jan 2025
Sources: Florida Department of State
