| Entity Name: | DOCTORS OUTPATIENT SURGERY CENTER OF JUPITER, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Aug 1999 (25 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 03 Mar 2022 (3 years ago) |
| Document Number: | L99000005027 |
| FEI/EIN Number | 650953183 |
| Address: | 14201 Dallas Parkway, Dallas, TX, 75254, US |
| Mail Address: | 14201 Dallas Parkway, Dallas, TX, 75254, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043303894 | 2006-10-02 | 2024-09-17 | 3602 KYOTO GARDENS DRIVE, PALM BEACH GARDENS, FL, 33410, US | 3602 KYOTO GARDENS DRIVE, PALM BEACH GARDENS, FL, 33410, US | |||||||||||||||||||||||||
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| Phone | +1 561-799-3388 |
| Fax | 5617993389 |
Authorized person
| Name | COLLIN LEMAISTRE |
| Role | AUTHORIZED OFFICIAL |
| Phone | 2142130732 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 1172 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 070793700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| Bowden James | Secretary | 14201 Dallas Parkway, Dallas, TX, 75254 |
| Name | Role | Address |
|---|---|---|
| Brodnax Brett | President | 14201 Dallas Parkway, Dallas, TX, 75254 |
| Name | Role |
|---|---|
| NATIONAL SURGERY CENTER HOLDINGS, INC. | Manager |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000041408 | LASER & SURGERY CENTER OF THE PALM BEACHES | ACTIVE | 2011-04-28 | 2027-12-31 | No data | 3602 KYOTO GARDENS DRIVE, PALM BEACH GARDENS, FL, 33410 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-03-03 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-03-03 | CT CORPORATION SYSTEM | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-15 | 14201 Dallas Parkway, Dallas, TX 75254 | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-15 | 14201 Dallas Parkway, Dallas, TX 75254 | No data |
| LC STMNT OF AUTHORITY | 2014-06-02 | No data | No data |
| LC AMENDMENT | 2014-06-02 | No data | No data |
| LC AMENDED AND RESTATED ARTICLES | 2014-06-02 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-06-02 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| CANCEL ADM DISS/REV | 2005-11-03 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-18 |
| REINSTATEMENT | 2022-03-03 |
| ANNUAL REPORT | 2020-06-15 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-03-30 |
| ANNUAL REPORT | 2017-04-17 |
| ANNUAL REPORT | 2016-04-08 |
| ANNUAL REPORT | 2015-04-16 |
| LC Amended and Restated Art | 2014-06-02 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
