| Entity Name: | ST. AUGUSTINE ARTIFICIAL KIDNEY CENTER, LTD. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Limited Partnership |
| Status: | Inactive |
| Date Filed: | 12 Oct 1994 (30 years ago) |
| Document Number: | A94000001392 |
| FEI/EIN Number | 650525721 |
| Mail Address: | 1299 E COMMERCIAL BLVD, SUITE 200, OAKLAND PARK, FL, 33334 |
| Address: | 1299 E.COMMERCIAL BOULEVARD, OAKLAND PARK, FL, 33334, US |
| ZIP code: | 33334 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013997600 | 2006-01-19 | 2020-08-22 | 7061 CYPRESS RD, SUITE 104, PLANTATION, FL, 333172243, US | 264 SOUTHPARK CIR E, ST AUGUSTINE, FL, 320865137, US | |||||||||||||||||||||||||
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| Phone | +1 954-474-7701 |
| Fax | 9544747702 |
| Phone | +1 904-808-0445 |
| Fax | 9048080446 |
Authorized person
| Name | MS. VICKI L BURRIER |
| Role | DIRECTOR/VICE-PRESIDENT |
| Phone | 9544747701 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BC/BS PROVIDER NO. |
| Number | V7A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BROWN JONNA J.D. | Agent | SABADELL BANK AND TRUST, NORTH PALM BEACH, FL, 33408 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LP CERTIFICATE OF DISSOLUTION | 2013-11-18 | No data | No data |
| AMENDMENT | 1997-07-03 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
