| Entity Name: | ROGER E BASSIN MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
ROGER E BASSIN MD PA is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 22 Jun 2005 (20 years ago) |
| Document Number: | P05000089213 |
| FEI/EIN Number |
202998816
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1705 BERGLUND LANE, SUITE 103, MELBOURNE, FL, 32940, US |
| Mail Address: | 1705 BERGLUND LANE, SUITE 103, MELBOURNE, FL, 32940, US |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588849780 | 2008-01-07 | 2024-07-17 | 1705 BERGLUND LN, SUITE 103, VIERA, FL, 329406231, US | 1705 BERGLUND LN, SUITE 103, VIERA, FL, 329406231, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 321-255-0025 |
| Fax | 3212550027 |
Authorized person
| Name | ROGER E BASSIN |
| Role | OWNER/OPERATOR |
| Phone | 3212550025 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | ME85585 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208200000X - Plastic Surgery Physician |
| License Number | ME85585 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2082S0099X - Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician |
| License Number | ME85585 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 2086S0122X - Plastic and Reconstructive Surgery Physician |
| License Number | ME85585 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | AH792 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BASSIN ROGER E | President | 1705 BERGLUND LANE, MELBOURNE, FL, 32940 |
| C T CORPORATION SYSTEM | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000023037 | OPPENHEIMER PLASTIC SURGERY | EXPIRED | 2016-03-03 | 2021-12-31 | - | 1705 BERGLUND LANE, SUITE 103, VIERA, FL, 32940 |
| G16000018297 | AQUA LIPO BODY SCULPTING CENTER | ACTIVE | 2016-02-19 | 2026-12-31 | - | 1705 BERGLUND LANE, SUITE 103, VIERA, FL, 32940 |
| G15000088253 | JACKSONVILLE HAIR RESTORATION CENTER | ACTIVE | 2015-08-26 | 2025-12-31 | - | 1705 BERGLUND LANE, SUITE 103, VIERA, FL, 32940 |
| G15000088257 | MELBOURNE HAIR RESTORATION CENTER | ACTIVE | 2015-08-26 | 2025-12-31 | - | 1705 BERGLUND LANE, SUITE 103, VIERA, FL, 32940 |
| G13000002398 | JACKSONVILLE HAIR RESTORATION | EXPIRED | 2013-01-07 | 2018-12-31 | - | 1705 BERGLUND LANE, SUITE 103, MELBOURNE, FL, 32940 |
| G12000084806 | TAMPA HAIR RESTORATION CENTER | ACTIVE | 2012-08-28 | 2027-12-31 | - | 1705 BERGLUND LANE, SUITE 103, VIERA, FL, 32940 |
| G12000075308 | ORLANDO HAIR MD | EXPIRED | 2012-07-30 | 2017-12-31 | - | 1705 BERGLUND LANE, SUITE 103, MELBOURNE, FL, 32940 |
| G12000075302 | ORLANDO HAIR RESTORATION CENTER | ACTIVE | 2012-07-30 | 2027-12-31 | - | 1705 BERGLUND LANE, SUITE 103, VIERA, FL, 32940 |
| G10000072040 | THE BASSIN CENTER FOR PLASTIC SURGERY | ACTIVE | 2010-08-05 | 2025-12-31 | - | 1705 BERGLUND LANE, SUITE 103, VIERA, FL, 32940 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-08-09 | C T CORPORATION SYSTEM | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-08-09 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-03 | 1705 BERGLUND LANE, SUITE 103, MELBOURNE, FL 32940 | - |
| CHANGE OF MAILING ADDRESS | 2009-04-03 | 1705 BERGLUND LANE, SUITE 103, MELBOURNE, FL 32940 | - |
| Name | Date |
|---|---|
| Reg. Agent Change | 2024-08-09 |
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-01-25 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-01-05 |
| ANNUAL REPORT | 2016-01-24 |
| FAIN | Awarding Agency | Assistance Listings | Start Date | End Date | Description | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 3239706002 | Small Business Administration | 59.041 - 504 CERTIFIED DEVELOPMENT LOANS | - | - | TO ASSIST SMALL BUSINESS CONCERNS BY PROVIDING LONG TERM FINANCING THROUGH THE SALE OF DEBENTURES TO THE PRIVATE SECTOR | |||||||||||||||||||
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| 3044636005 | Small Business Administration | 59.041 - 504 CERTIFIED DEVELOPMENT LOANS | - | - | TO ASSIST SMALL BUSINESS CONCERNS BY PROVIDING LONG TERM FINANCING THROUGH THE SALE OF DEBENTURES TO THE PRIVATE SECTOR | |||||||||||||||||||
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| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6108657000 | 2020-04-06 | 0455 | PPP | 1705 BERGLUND LN STE 103, MELBOURNE, FL, 32940-6230 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Apr 2025
Sources: Florida Department of State
