| Entity Name: | COASTAL SURGERY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
COASTAL SURGERY CENTER, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 25 Oct 2004 (20 years ago) |
| Document Number: | L04000077462 |
| FEI/EIN Number |
202667835
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4147 SOUTHPOINT DR E, JACKSONVILLE, FL, 32216 |
| Mail Address: | 4147 SOUTHPOINT DR E, JACKSONVILLE, FL, 32216 |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902832405 | 2006-06-25 | 2020-08-22 | 4147 SOUTHPOINT DR E, JACKSONVILLE, FL, 322160996, US | 4147 SOUTHPOINT DR E, JACKSONVILLE, FL, 322160996, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 904-332-6774 |
| Fax | 9043329137 |
Authorized person
| Name | SANDRA A HARMS |
| Role | ADMINISTRATOR |
| Phone | 9043326774 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 14960580 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 6N6 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FEE TIMOTHY E | Manager | 4147 SOUTHPOINT DR E, JACKSONVILLE, FL, 32216 |
| FEE TIMOTHY E | Agent | 4147 SOUTHPOINT DRIVE EAST, JACKSONVILLE, FL, 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2025-01-13 | FEE, TIMOTHY E, dr | - |
| REGISTERED AGENT NAME CHANGED | 2008-03-27 | FEE, TIMOTHY EM.D. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2008-03-27 | 4147 SOUTHPOINT DRIVE EAST, JACKSONVILLE, FL 32216 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2006-01-03 | 4147 SOUTHPOINT DR E, JACKSONVILLE, FL 32216 | - |
| CHANGE OF MAILING ADDRESS | 2006-01-03 | 4147 SOUTHPOINT DR E, JACKSONVILLE, FL 32216 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-13 |
| ANNUAL REPORT | 2024-01-17 |
| ANNUAL REPORT | 2023-01-05 |
| ANNUAL REPORT | 2022-01-16 |
| ANNUAL REPORT | 2021-01-10 |
| ANNUAL REPORT | 2020-03-18 |
| ANNUAL REPORT | 2019-01-28 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-07-07 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 336041207 | 0419700 | 2012-08-24 | 4147 SOUTHPOINT DR. E., JACKSONVILLE, FL, 32216 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Citation ID | 01001 |
| Citaton Type | Serious |
| Standard Cited | 19101030 D02 I |
| Issuance Date | 2012-11-29 |
| Abatement Due Date | 2013-01-17 |
| Current Penalty | 1540.0 |
| Initial Penalty | 2800.0 |
| Final Order | 2012-12-20 |
| Nr Instances | 1 |
| Nr Exposed | 4 |
| Gravity | 10 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(d)(2)(i): Engineering and work practice controls were not used to eliminate or minimize employees exposure: a. On or about August 24, 2012, the employer used a scapel that did not have a safety device that would prevent or minimize employee's exposure to bloodborne pathogens while assisting in a surgery or disinfecting equipment. |
| Citation ID | 01002 |
| Citaton Type | Serious |
| Standard Cited | 19101030 D04 IV A 3 |
| Issuance Date | 2012-11-29 |
| Abatement Due Date | 2012-12-26 |
| Current Penalty | 1540.0 |
| Initial Penalty | 2800.0 |
| Final Order | 2012-12-20 |
| Nr Instances | 1 |
| Nr Exposed | 10 |
| Gravity | 10 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(d)(4)(iv)(A)(3): Whenever contaminated laundry was wet and presented a reasonable likelihood of soak-through of or leakage from the bag or container, the laundry was not placed or transported in bags or containers which prevented soak-through and/or leakage of fluids to the exterior: a. On or about August 24, 2012, the employer placed wet mop heads used in the operating rooms to disinfect the floors after a surgery inside cloth type laundry bags and later the bags were stored in the soiled laundry room. The laundry bags used for these purposes did not prevented soak-through and/or leakeage of fluids to the exterior of the bag. |
| Citation ID | 01003 |
| Citaton Type | Serious |
| Standard Cited | 19101030 F03 V |
| Issuance Date | 2012-11-29 |
| Abatement Due Date | 2012-12-26 |
| Current Penalty | 1320.0 |
| Initial Penalty | 2400.0 |
| Final Order | 2012-12-20 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(f)(3)(v): The post-exposure evaluation and follow-up of an exposure incident did not include counseling: a. On or about August 24, 2012, an employee assisting the doctor on a surgery was injured while passing a contaminated suture needle to the surgeon and the post-exposure evaluation did not include counseling. |
| Citation ID | 02001 |
| Citaton Type | Other |
| Standard Cited | 19101048 D01 I |
| Issuance Date | 2012-11-29 |
| Abatement Due Date | 2013-01-17 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2012-12-20 |
| Nr Instances | 1 |
| Nr Exposed | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1048(d)(1)(i): Employees of a workplace covered by this standard were not monitored to determine their exposure to formaldehyde: a. On or about August 24, 2012, in the soil laundry room, employees poured into a container a 10% Formalin solution to preserve human tissue and the employer have not conducted an initial monitoring to determine their exposure to formaldehyde. |
| Citation ID | 02002 |
| Citaton Type | Other |
| Standard Cited | 19101048 M01 II |
| Issuance Date | 2012-11-29 |
| Abatement Due Date | 2012-12-26 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2012-12-20 |
| Nr Instances | 1 |
| Nr Exposed | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1048(m)(1)(ii): As a minimum, the employer did not address the specific health hazards of cancer, irritation and sensitization of the skin and respiratory system, eye and throat irritation, and acute toxicity with employees who were exposed to formaldehyde: a. On or about August 24, 2012, employees poured into a container a 10% Formalin solution to preserve tissue and the employer had not provided the minimum information on the specific health hazards of formaldehyde to the employees who had potential occupation exposure to this chemical. |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4993417110 | 2020-04-13 | 0491 | PPP | 4147 Southpoint Dr E., JACKSONVILLE, FL, 32216 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of last update: 01 Apr 2025
Sources: Florida Department of State
