Detail by Officer/Registered Agent Name

Florida Profit Corporation

SPACE COAST OUTPATIENT ENDOSCOPY SERVICES, INC.

Filing Information
P96000025197 59-3369073 03/20/1996 03/18/1996 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 10/16/1998 NONE
Principal Address
9620 EXECUTIVE CENTER DRIVE, SUITE 125
ST. PETERSBURG, FL 33702
Mailing Address
9620 EXECUTIVE CENTER DRIVE, SUITE 125
ST. PETERSBURG, FL 33702
Registered Agent Name & Address BRONSTEIN, JOEL DESQUIRE
150 SECOND AVENUE NORTH
SUITE 1100
ST. PETERSBURG, FL 33701
Officer/Director Detail Name & Address

Title P

GOMEZ, REX L
1273 S FLORIDA AVE
ROCKLEDGE, FL

Title ST

LANE, TIMOTHY G MD
1257 S FLORIDA AVE
ROCKLEDGE, FL

Title D

LACANO, ABELARDO V MD
300 FORTENBERRY RD
MERRITT ISLAND, FL

Title D

TOBKES, ANDREW MD
1257 S FLORIDA AVE
ROCKLEDGE, FL

Title D

WEBER, RICHARD MD
1007 BEVERLY DR
ROCKLEDGE, FL

Annual Reports
Report YearFiled Date
1997 05/12/1997