| Entity Name: | VINYARD INSTITUTE OF PLASTIC SURGERY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 24 May 2018 (7 years ago) |
| Document Number: | L18000129840 |
| FEI/EIN Number | 83-0674994 |
| Address: | 291 NW PEACOCK BLVD, SUITE 104, PORT SAINT LUCIE, FL 34986 |
| Mail Address: | 151 MANOR CIRCLE, JUPITER, FL 33458 |
| ZIP code: | 34986 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760976708 | 2018-06-21 | 2018-06-21 | 151 MANOR CIR, JUPITER, FL, 334581642, US | 291 NW PEACOCK BLVD STE 104, PORT ST LUCIE, FL, 349862214, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 913-244-7254 |
Authorized person
| Name | DR. WILLIAM J WINYARD |
| Role | OWNER |
| Phone | 9132447254 |
Taxonomy
| Taxonomy Code | 208200000X - Plastic Surgery Physician |
| License Number | ME120069 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAL LICENSE |
| Number | ME120069 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VINYARD INSTITUTE OF PLASTIC SURGERY LLC 401K PROFIT SHARING PLAN | 2023 | 830674994 | 2024-07-23 | VINYARD INSTITUTE OF PLASTIC SURGERY LLC | 5 | |||||||||||||
|
||||||||||||||||||
| Name | Role | Address |
|---|---|---|
| VINYARD, GINA M | Agent | 151 MANOR CIRCLE, JUPITER, FL 33458 |
| Name | Role | Address |
|---|---|---|
| VINYARD, WILLIAM J | President | 151 MANOR CIRCLE, JUPITER, FL 33458 |
| Name | Role | Address |
|---|---|---|
| VINYARD, GINA M | Vice President | 151 MANOR CIRCLE, JUPITER, FL 33458 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-06-15 | 291 NW PEACOCK BLVD, SUITE 104, PORT SAINT LUCIE, FL 34986 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-25 |
| ANNUAL REPORT | 2023-02-15 |
| ANNUAL REPORT | 2022-03-04 |
| ANNUAL REPORT | 2021-02-11 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-03-10 |
| Florida Limited Liability | 2018-05-24 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
