| Entity Name: | SOUTHEASTERN PLASTIC SURGERY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Oct 2001 (23 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 01 Dec 2004 (20 years ago) |
| Document Number: | P01000103578 |
| FEI/EIN Number | 593756207 |
| Address: | 2030 FLEISCHMANN RD, 2030 FLEISCHMANN RD, Tallahassee, FL, 32308, US |
| Mail Address: | 2030 FLEISCHMANN RD, 2030 FLEISCHMANN RD, Tallahassee, FL, 32308, US |
| ZIP code: | 32308 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801989884 | 2006-10-02 | 2016-11-10 | 2030 FLEISCHMANN RD, TALLAHASSEE, FL, 32308, US | 2030 FLEISCHMANN RD, TALLAHASSEE, FL, 32308, US | |||||||||||||||
|
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| Phone | +1 850-219-2000 |
| Fax | 8508772138 |
Authorized person
| Name | MR. BEN J KIRBO |
| Role | SURGEON/OWNER |
| Phone | 8502192000 |
Taxonomy
| Taxonomy Code | 2086S0122X - Plastic and Reconstructive Surgery Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DARLING VIRGINIA | Agent | 2030 FLEISCHMANN RD, Tallahassee, FL, 32308 |
| Name | Role | Address |
|---|---|---|
| Kirbo Ben M | Director | 2030 FLEISCHMANN RD, Tallahassee, FL, 32308 |
| Name | Role | Address |
|---|---|---|
| Kirbo Ben M | President | 2030 FLEISCHMANN RD, Tallahassee, FL, 32308 |
| Name | Role | Address |
|---|---|---|
| Kirbo Ben M | Secretary | 2030 FLEISCHMANN RD, Tallahassee, FL, 32308 |
| Name | Role | Address |
|---|---|---|
| Kirbo Ben M | Treasurer | 2030 FLEISCHMANN RD, Tallahassee, FL, 32308 |
| Name | Role | Address |
|---|---|---|
| Rosenberg Laurence M | Managing Member | 2030 FLEISCHMANN RD, Tallahassee, FL, 32308 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-05-11 | 2030 FLEISCHMANN RD, 2030 FLEISCHMANN RD, Tallahassee, FL 32308 | No data |
| CHANGE OF MAILING ADDRESS | 2023-05-11 | 2030 FLEISCHMANN RD, 2030 FLEISCHMANN RD, Tallahassee, FL 32308 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-05-11 | 2030 FLEISCHMANN RD, 2030 FLEISCHMANN RD, Tallahassee, FL 32308 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-01-06 | DARLING, VIRGINIA | No data |
| REINSTATEMENT | 2004-12-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| AMENDED ANNUAL REPORT | 2023-05-11 |
| AMENDED ANNUAL REPORT | 2023-05-10 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-01-25 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-18 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-10 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
