| Entity Name: | MELBOURNE & PALM BAY NEPHROLOGY INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 28 Jul 2005 (20 years ago) |
| Date of dissolution: | 08 Feb 2014 (11 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 08 Feb 2014 (11 years ago) |
| Document Number: | P05000105884 |
| FEI/EIN Number | 203232627 |
| Address: | 787 37th St. Suite E-220, Vero Beach, FL, 32960, US |
| Mail Address: | 1110 BOUNTY BLVD, VERO BEACH, FL, 32963 |
| ZIP code: | 32960 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124217328 | 2007-10-24 | 2008-11-18 | 7770 BAY ST, SUITE 13, SEBASTIAN, FL, 329583427, US | 7770 BAY ST, SUITE 13, SEBASTIAN, FL, 329583427, US | |||||||||||||||||||||||||
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| Phone | +1 772-581-2750 |
| Fax | 7725818362 |
Authorized person
| Name | DR. MARCHELLE KAY HOFELDT |
| Role | OWNER, SOLE ENTITY |
| Phone | 7725812750 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| License Number | ME82565 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 261687400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HOFELDT MARCHELLE MD | Agent | 1110 BOUNTY BLVD, VERO BEACH, FL, 32963 |
| Name | Role | Address |
|---|---|---|
| HOFELDT MARCHELLE MD | President | 1110 BOUNTY BLVD, VERO BEACH, FL, 32963 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2014-02-08 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-01-12 | 787 37th St. Suite E-220, Vero Beach, FL 32960 | No data |
| CHANGE OF MAILING ADDRESS | 2009-03-23 | 787 37th St. Suite E-220, Vero Beach, FL 32960 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-03-23 | 1110 BOUNTY BLVD, VERO BEACH, FL 32963 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2014-02-08 |
| ANNUAL REPORT | 2013-01-12 |
| ANNUAL REPORT | 2012-01-19 |
| ANNUAL REPORT | 2011-01-31 |
| ANNUAL REPORT | 2010-02-19 |
| ANNUAL REPORT | 2009-03-23 |
| ANNUAL REPORT | 2008-01-05 |
| ANNUAL REPORT | 2007-04-25 |
| ANNUAL REPORT | 2006-04-27 |
| Domestic Profit | 2005-07-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
