| Entity Name: | INSTITUTE OF FACIAL SURGERY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 29 Aug 2001 (23 years ago) |
| Document Number: | P01000085455 |
| FEI/EIN Number | 59-3740807 |
| Address: | 1093 SOUTH WICKHAM ROAD, MELBOURNE, FL 32904 |
| Mail Address: | 1093 SOUTH WICKHAM ROAD, MELBOURNE, FL 32904 |
| ZIP code: | 32904 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386855096 | 2007-05-24 | 2010-08-24 | 1093 S WICKHAM RD, WEST MELBOURNE, FL, 329041652, US | 1093 S WICKHAM RD, WEST MELBOURNE, FL, 329041652, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 321-674-3900 |
| Fax | 3217223303 |
Authorized person
| Name | DR. LANCE F GRENEVICKI |
| Role | OWNERDOCTOR |
| Phone | 3216743900 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 429 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GRENEVICKI, LANCE F | Agent | 1093 S WICKHAM ROAD, MELBOURNE, FL 32904 |
| Name | Role | Address |
|---|---|---|
| GRENEVICKI, LANCE F | Director | 1093 WICKHAM ROAD, MELBOURNE, FL 32904-1652 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2009-01-17 | 1093 SOUTH WICKHAM ROAD, MELBOURNE, FL 32904 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-01-07 | 1093 SOUTH WICKHAM ROAD, MELBOURNE, FL 32904 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-01-03 | 1093 S WICKHAM ROAD, MELBOURNE, FL 32904 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-04-02 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-26 |
| ANNUAL REPORT | 2015-01-12 |
Date of last update: 31 Jan 2025
Sources: Florida Department of State
