| Entity Name: | CUSTOM LONGEVITY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Sep 2018 (6 years ago) |
| Document Number: | P18000078081 |
| FEI/EIN Number | 83-1938352 |
| Address: | 4005 GULF SHORE BLVD N, # 402, NAPLES, FL, 34103 |
| Mail Address: | 4005 GULF SHORE BLVD N, # 402, NAPLES, FL, 34103 |
| ZIP code: | 34103 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306312731 | 2018-10-24 | 2018-10-24 | 4005 GULF SHORE BLVD N APT 402, NAPLES, FL, 341033433, US | 4005 GULF SHORE BLVD N APT 402, NAPLES, FL, 341033433, US | |||||||||||||
|
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| Phone | +1 917-292-8074 |
Authorized person
| Name | DR. SVETLANA KOGAN |
| Role | OWNER |
| Phone | 9172928074 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KOGAN SVETLANA M.D. | Agent | 4005 GULF SHORE BLVD N, NAPLES, FL, 34103 |
| Name | Role | Address |
|---|---|---|
| KOGAN SVETLANA M.D. | President | 4005 GULF SHORE BLVD N, #402, NAPLES, FL, 34103 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-17 | 720 Fifth Avenue South, SUITE 209, NAPLES, FL 34102 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-17 |
| ANNUAL REPORT | 2024-01-24 |
| ANNUAL REPORT | 2023-01-22 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-01-09 |
| ANNUAL REPORT | 2019-01-04 |
| Domestic Profit | 2018-09-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
