| Entity Name: | INFINITY HEALTHCARE PORT SAINT LUCIE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 13 May 2024 (9 months ago) |
| Document Number: | L24000220683 |
| Address: | 1226 SE PORT ST LUCIE BLVD, PORT SAINT LUCIE, FL 34952 |
| Mail Address: | 8890 WEST OAKLAND PARK BLVD., 200, SUNRISE, FL 33351 |
| ZIP code: | 34952 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417785775 | 2024-07-26 | 2024-07-26 | 8890 W OAKLAND PARK BLVD STE 200, SUNRISE, FL, 333517221, US | 1226 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL, 349525364, US | |||||||||||||||||||||
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| Phone | +1 954-741-3304 |
| Fax | 7542226417 |
| Phone | +1 772-666-1801 |
Authorized person
| Name | JOSEPH DI CAPUA |
| Role | CEO |
| Phone | 5618437720 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| DI CAPUA, JOSEPH | Agent | 8890 WEST OAKLAND PARK BLVD., SUITE 200, SUNRISE, FL 33351 |
| Name | Role | Address |
|---|---|---|
| DI CAPUA, JOSEPH | Manager | 8890 WEST OAKLAND PARK BLVD. SUITE 200, SUNRISE, FL 33351 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-05-13 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
