| Entity Name: | SUNSHINE THORACIC SURGERY PL |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 20 Mar 2008 (17 years ago) |
| Date of dissolution: | 26 Apr 2010 (15 years ago) |
| Last Event: | LC VOLUNTARY DISSOLUTION |
| Event Date Filed: | 26 Apr 2010 (15 years ago) |
| Document Number: | L08000028939 |
| FEI/EIN Number | 800160979 |
| Address: | 11316 AUDRAIN RD, 9907, MEXICO, MO, 65265, US |
| Mail Address: | PO BOX 691, MEXICO, MO, 65265 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578734497 | 2008-03-19 | 2008-05-16 | 121 WEBB DR, SUITE #300, DAVENPORT, FL, 338373904, US | 121 WEBB DR, SUITE #300, DAVENPORT, FL, 338373904, US | |||||||||||||||||||||||||||||||
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| Phone | +1 863-422-0022 |
| Fax | 8634221005 |
Authorized person
| Name | JOSEPH M FUGARO |
| Role | OWNER |
| Phone | 8634220022 |
Taxonomy
| Taxonomy Code | 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | ME 101026 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 281007700 |
| State | FL |
| Issuer | MEDICAID |
| Number | 201257300 |
| State | MO |
| Name | Role |
|---|---|
| UNITED STATES CORPORATION AGENTS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| FUGARO PAULA S | Manager | 11316 AUDRAIN RD, 9907, MEXICO, MO, 65265 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-18 | 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 | No data |
| LC VOLUNTARY DISSOLUTION | 2010-04-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-06-30 | 11316 AUDRAIN RD, 9907, MEXICO, MO 65265 | No data |
| Name | Date |
|---|---|
| LC Voluntary Dissolution | 2010-04-26 |
| ANNUAL REPORT | 2009-03-27 |
| Florida Limited Liability | 2008-03-20 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
