| Entity Name: | FITZSIMMONS SURGICAL SUPPLY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit Corporation |
| Status: | Active |
| Date Filed: | 31 Mar 2022 (3 years ago) |
| Document Number: | F22000001912 |
| FEI/EIN Number | 36-2677861 |
| Address: | 1450 SW 3rd ST, A-10, Pompano Beach, FL 33069 |
| Mail Address: | 8000 186TH ST, TINLEY PARK, IL 60487 |
| ZIP code: | 33069 |
| County: | Broward |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518674142 | 2022-11-02 | 2023-12-18 | PO BOX 1127, TINLEY PARK, IL, 604777927, US | 1450 SW 3RD ST STE A-10, POMPANO BEACH, FL, 330693215, US | |||||||||||||||||||||||||
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| Phone | +1 708-532-1199 |
| Fax | 7085324499 |
| Phone | +1 954-363-1305 |
| Fax | 9546038976 |
Authorized person
| Name | THOMAS FITZSIMMONS |
| Role | PRESIDENT |
| Phone | 7085321199 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 118472300 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| FITZSIMMONS, JAMES | President | 8000 186TH ST, TINLEY PARK, IL 60487 |
| Name | Role | Address |
|---|---|---|
| FITZSIMMONS, JAMES | Director | 8000 186TH ST, TINLEY PARK, IL 60487 |
| FITZSIMMONS, THOMAS | Director | 8000 186TH ST, TINLEY PARK, IL 60487 |
| Name | Role | Address |
|---|---|---|
| FITZSIMMONS, THOMAS | Secretary | 8000 186TH ST, TINLEY PARK, IL 60487 |
| Name | Role | Address |
|---|---|---|
| Fitzsimmons, Brian | Treasurer | 8000 W. 186th Street, Tinley Park, IL 60487 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-06 | 1450 SW 3rd ST, A-10, Pompano Beach, FL 33069 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-20 | 1450 SW 3rd ST, A-10, Pompano Beach, FL 33069 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| AMENDED ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2023-02-20 |
| Foreign Profit | 2022-03-31 |
Date of last update: 12 Jan 2025
Sources: Florida Department of State
