| Entity Name: | TREASURE COAST MEDICAL CENTERS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 22 May 2024 (9 months ago) |
| Document Number: | L24000238319 |
| FEI/EIN Number | 99-3314487 |
| Address: | 1801 SE HILLMOOR DRIVE, SUIT C-110, PORT ST LUCIE, FL 34952 |
| Mail Address: | 1801 SE HILLMOOR DRIVE, SUIT C-110, PORT ST LUCIE, FL 34952 |
| ZIP code: | 34952 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710723721 | 2024-07-08 | 2024-07-08 | 1801 SE HILLMOOR DR STE C-110, PORT ST LUCIE, FL, 349527575, US | 1801 SE HILLMOOR DR STE C-110, PORT ST LUCIE, FL, 349527575, US | |||||||||||||||||||||
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| Phone | +1 305-879-0565 |
Authorized person
| Name | MS. NORIALYS FUMERO |
| Role | CLINICAL DIRECTOR |
| Phone | 3058790565 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| MALCOLM DEPESTRE, DAVID M, CEO | Agent | 1801 SE HILLMOOR DRIVE, C-110, PORT ST LUCIE, FL 35952 |
| Name | Role | Address |
|---|---|---|
| SUAREZ, ANA | Authorized Member | 1333 SW AXTELL AVENUE, PORT ST LUCIE, FL 35953 |
| FUMERO, NORIALYS | Authorized Member | 644 NE LARKSPUR LANE, PORT ST LUCIE, FL 34953 |
| MALCOLM DEPESTRE, DAVID M | Authorized Member | 1801 SE HILLMOOR DRIVE, SUIT C-110 PORT SAINT LUCIE, FL 34952 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2025-01-09 | MALCOLM DEPESTRE, DAVID M, CEO | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2025-01-09 | 1801 SE HILLMOOR DRIVE, C-110, PORT ST LUCIE, FL 35952 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-14 | 1801 SE HILLMOOR DRIVE, SUIT C-110, PORT ST LUCIE, FL 34952 | No data |
| CHANGE OF MAILING ADDRESS | 2024-10-14 | 1801 SE HILLMOOR DRIVE, SUIT C-110, PORT ST LUCIE, FL 34952 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-09 |
| Florida Limited Liability | 2024-05-22 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
