| Entity Name: | GULF COAST PLASTIC SURGERY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Mar 2023 (2 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 31 Mar 2023 (2 years ago) |
| Document Number: | L23000113651 |
| FEI/EIN Number | 92-3363741 |
| Address: | 543 FONTAINE STREET, PENSACOLA, FL, 32503, US |
| Mail Address: | 543 FONTAINE STREET, PENSACOLA, FL, 32503, US |
| ZIP code: | 32503 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477322345 | 2023-12-20 | 2024-10-24 | 539 FONTAINE ST, PENSACOLA, FL, 325032018, US | 539 FONTAINE ST, PENSACOLA, FL, 325032018, US | |||||||||||||||
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| Phone | +1 850-476-3440 |
| Fax | 8507415099 |
Authorized person
| Name | DR. PETER N BUTLER |
| Role | OWNER/PLASTIC SURGEON |
| Phone | 8504763223 |
Taxonomy
| Taxonomy Code | 2086S0122X - Plastic and Reconstructive Surgery Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MITCHEM WILLIAM HESQ | Agent | 501 COMMENDENCIA STREET, PENSACOLA, FL, 32502 |
| Name | Role | Address |
|---|---|---|
| PETER BUTLER | Manager | 543 FONTAINE STREET, PENSACOLA, FL, 32503 |
| JOCELYN LEVEQUE | Manager | 543 FONTAINE STREET, PENSACOLA, FL, 32503 |
| NATHAN PATTERSON | Manager | 543 FONTAINE STREET, PENSACOLA, FL, 32503 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC NAME CHANGE | 2023-03-31 | GULF COAST PLASTIC SURGERY CENTER, LLC | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-07-30 |
| ANNUAL REPORT | 2024-03-05 |
| LC Name Change | 2023-03-31 |
| Florida Limited Liability | 2023-03-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
