| Entity Name: | WEST PALM OUTPATIENT SURGERY AND LASER CENTER, LTD. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Limited Partnership |
| Status: | Active |
| Date Filed: | 10 May 1995 (30 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 06 Feb 2004 (21 years ago) |
| Document Number: | A95000000738 |
| FEI/EIN Number | 650592518 |
| Address: | 1A BURTON HILLS BLVD, NASHVILLE, TN, 37215, US |
| Mail Address: | 1A BURTON HILLS BLVD, NASHVILLE, TN, 37215, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841298437 | 2005-07-08 | 2023-09-07 | 200 NORTHPOINT PKWY, WEST PALM BEACH, FL, 334071967, US | 200 NORTHPOINT PKWY, WEST PALM BEACH, FL, 334071967, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 561-615-0110 |
| Fax | 5616158009 |
Authorized person
| Name | MS. BILLIE A. PAYNE |
| Role | PRESIDENT |
| Phone | 6156651283 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 1035 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | 490003237 |
| State | FL |
| Issuer | MEDICAID |
| Number | 079220900 |
| State | FL |
| Issuer | BLUE CROSS PROVIDER NUMBE |
| Number | 66F |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-24 | 1A BURTON HILLS BLVD, SUITE 300, NASHVILLE, TN 37215 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-24 | 1A BURTON HILLS BLVD, SUITE 300, NASHVILLE, TN 37215 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-05-17 | 1201 HAYS ST, TALLAHASSEE, FL 32301 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-05-17 | CORPORATION SERVICE COMPANY | No data |
| AMENDMENT | 2004-02-06 | No data | No data |
| CONTRIBUTION CHANGE | 2004-01-20 | No data | No data |
| NAME CHANGE AMENDMENT | 2003-09-15 | WEST PALM OUTPATIENT SURGERY AND LASER CENTER, LTD. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-03 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-04-26 |
| Reg. Agent Change | 2017-05-17 |
| ANNUAL REPORT | 2017-04-20 |
| ANNUAL REPORT | 2016-03-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
