| Entity Name: | PORT ST. LUCIE OPERATING CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 26 Sep 2000 (24 years ago) |
| Document Number: | P00000090831 |
| FEI/EIN Number | 272116805 |
| Address: | 3553 SW Corporate Parkway, Palm City, FL, 34990, US |
| Mail Address: | 3553 SW Corporate Parkway, Palm City, FL, 34990, US |
| ZIP code: | 34990 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730259466 | 2006-11-09 | 2010-06-02 | 7300 OLEANDER AVE, PORT ST LUCIE, FL, 349528221, US | 7300 OLEANDER AVE, PORT ST LUCIE, FL, 349528221, US | |||||||||||||||||||||||||
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| Phone | +1 772-464-5911 |
| Phone | +1 772-466-4100 |
Authorized person
| Name | JOSEPH FICOCELLO |
| Role | PRESIDENT |
| Phone | 7724645911 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 206580 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 022600900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FICOCELLO JOSEPH GPRESIDE | Agent | 3553 SW Corporate Parkway, Palm City, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| HOFFMAN SCOTT H | Chief Executive Officer | 3553 SW Corporate Pkwy, PALM CITY, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| FICOCELLO JOSEPH G | President | 3553 SW Corporate Pkwy, Palm City, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| BERNINI ANTHONY | Secretary | 168 NORTH LAKE AVENUE, TROY, NY, 12180 |
| Name | Role | Address |
|---|---|---|
| CRISPIN MARY M | Asst | 3553 SW Corporate Pkwy, Palm City, FL, 34990 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2021-04-14 | FICOCELLO, JOSEPH G., PRESIDENT | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-02-11 | 3553 SW Corporate Parkway, Palm City, FL 34990 | No data |
| CHANGE OF MAILING ADDRESS | 2020-02-11 | 3553 SW Corporate Parkway, Palm City, FL 34990 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-02-11 | 3553 SW Corporate Parkway, Palm City, FL 34990 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-03-09 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-02-11 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-03-20 |
| ANNUAL REPORT | 2017-02-01 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-01-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
