| Entity Name: | MD VIERA HEALTHCARE PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 25 Sep 2015 (9 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | P15000079508 |
| Address: | 7000 SPYGLASS COURT, SUITE 130, MELBOURNE, FL 32940 |
| Mail Address: | 7000 SPYGLASS COURT, SUITE 130, MELBOURNE, FL 32940 |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730551664 | 2015-10-30 | 2015-11-20 | 7000 SPYGLASS COURT, STE 130, MELBOURNE, FL, 32940, US | 7000 SPYGLASS CT, MELBOURNE, FL, 329408288, US | |||||||||||||||||||
|
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| Phone | +1 321-544-5298 |
| Fax | 8883703210 |
Authorized person
| Name | LOQUITA ALLAIRE |
| Role | AGENT |
| Phone | 3215445298 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME85264 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FOSTER, ALFONSO | Agent | BOX 101425, MELBOURNE, FL 32941 |
| Name | Role | Address |
|---|---|---|
| MCELYNN, KENNETH R, MD | President | 700 SPYGLASS COURT SUITE 130, MELBOURNE, FL 32940 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2015-09-25 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
