| Entity Name: | COAST MULTI SPECIALTY MEDICAL GROUP, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
COAST MULTI SPECIALTY MEDICAL GROUP, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 04 Oct 2000 (25 years ago) |
| Document Number: | P00000093911 |
| FEI/EIN Number |
593683041
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4251 NW American Ln, LAKE CITY, FL, 32055, US |
| Mail Address: | PO BOX 1762, LAKE CITY, FL, 32056 |
| ZIP code: | 32055 |
| County: | Columbia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306971833 | 2007-02-23 | 2014-12-23 | PO BOX 1762, LAKE CITY, FL, 320561762, US | 480 SW MAIN BLVD, LAKE CITY, FL, 320255269, US | |||||||||||||||||||||||||
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| Phone | +1 386-758-1965 |
| Fax | 3867586923 |
Authorized person
| Name | DR. J. ANTHONY TROTT |
| Role | PRESIDENT |
| Phone | 3867581965 |
Taxonomy
| Taxonomy Code | 207NS0135X - Procedural Dermatology Physician |
| License Number | ME80264 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE GROUP PTAN |
| Number | K2456 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TROTT J. ANTHONY M | Director | PO BOX 1762, LAKE CITY, FL, 32056 |
| TROTT J. ANTHONY M | President | PO BOX 1762, LAKE CITY, FL, 32056 |
| TROTT J. ANTHONY M | Secretary | PO BOX 1762, LAKE CITY, FL, 32056 |
| TROTT J. ANTHONY M | Agent | 4251 NW American Ln, LAKE CITY, FL, 32025 |
| TROTT J. ANTHONY M | Treasurer | PO BOX 1762, LAKE CITY, FL, 32056 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000069718 | COSMETIC DERMATOLOGY AND LASER CENTER | EXPIRED | 2012-07-12 | 2017-12-31 | - | P O BOX 1762, LAKE CITY, FL, 32056 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-25 | 4251 NW American Ln, 102, LAKE CITY, FL 32055 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-25 | 4251 NW American Ln, Lake City, FL 32055102, LAKE CITY, FL 32025 | - |
| CHANGE OF MAILING ADDRESS | 2003-04-28 | 4251 NW American Ln, 102, LAKE CITY, FL 32055 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-25 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-02-16 |
| ANNUAL REPORT | 2021-04-23 |
| ANNUAL REPORT | 2020-05-06 |
| ANNUAL REPORT | 2019-04-21 |
| ANNUAL REPORT | 2018-04-13 |
| ANNUAL REPORT | 2017-04-13 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-04-21 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 339640237 | 0419700 | 2014-03-18 | 480 SW MAIN BLVD, LAKE CITY, FL, 32025 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Type | Complaint |
| Activity Nr | 876179 |
| Health | Yes |
Violation Items
| Citation ID | 01001A |
| Citaton Type | Serious |
| Standard Cited | 19101030 F02 I |
| Issuance Date | 2014-06-23 |
| Current Penalty | 2000.0 |
| Initial Penalty | 2000.0 |
| Final Order | 2014-07-14 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Related Event Code (REC) | Complaint |
| Gravity | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(f)(2)(i): Hepatitis B vaccination was not made available within 10 working days of initial assignment to all employee(s) with occupational exposure: a. On or about March 18, 2014, a medical assistant was exposed to bloodborne pathogen hazards while assisting the physician during surgeries and the employer did not offer the Hepatitis B vaccination series within 10 working days of initial assignment. |
| Citation ID | 01001B |
| Citaton Type | Serious |
| Standard Cited | 19101030 G02 VII |
| Issuance Date | 2014-06-23 |
| Abatement Due Date | 2014-07-18 |
| Current Penalty | 0.0 |
| Initial Penalty | 2000.0 |
| Final Order | 2014-07-14 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Related Event Code (REC) | Complaint |
| Gravity | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(g)(2)(vii): The employer's training program did not contain the minimum elements required by 29 CFR 1910.1030(g)(2)(vii)(A) through (g)(2)(vii)(N): a. On or about March 18, 2014, the bloodborne pathogens training provided to the employees did not contain all the minimum elements required under the bloodborne pathogens training program. The training did not include: 1. An accessible copy of the regulatory text of this standard and an explanation of its contents; 2. A general explanation of the epidemiology and symptoms of bloodborne diseases; 3. An explanation of the modes of transmission of bloodborne pathogens; 4. An explanation of the employer's exposure control plan and the means by which the employee can obtain a copy of the written plan; 5. An explanation of the appropriate methods for recognizing tasks and other activities that may involve exposure to blood and other potentially infectious materials; 6. An explanation of the basis for selection of personal protective equipment; 7. Information on the hepatitis B vaccine, including information on its efficacy, safety, method of administration, the benefits of being vaccinated, and that the vaccine and vaccination will be offered free of charge; 8. Information on the appropriate actions to take and persons to contact in an emergency involving blood or other potentially infectious materials; 9. An explanation of the procedure to follow if an exposure incident occurs, including the method of reporting the incident and the medical follow-up that will be made available; and 10. Information on the post-exposure evaluation and follow-up that the employer is required to provide for the employee following an exposure incident. |
| Citation ID | 02001A |
| Citaton Type | Other |
| Standard Cited | 19101030 C01 IV |
| Issuance Date | 2014-06-23 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2014-07-14 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| Related Event Code (REC) | Complaint |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(c)(1)(iv): The Exposure Control Plan was not reviewed and updated at least annually: a. On or about March 18, 2014, the employer had a written Exposure Control Plan that had not been reviewed at least annually to include all elements required under the OSHA standard. The Safety Officer identified in the program was an employee that no longer worked at the office and was reviewed in 2002. |
| Citation ID | 02001B |
| Citaton Type | Other |
| Standard Cited | 19101030 C01 V |
| Issuance Date | 2014-06-23 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2014-07-14 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Related Event Code (REC) | Complaint |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(c)(1)(v): The employer, who is required to establish an Exposure Control Plan, did not solicit input from non-managerial employees responsible for direct patient care who are potentially exposed to injuries from contaminated sharps in the identification, evaluation and selection of effective engineering and work practice controls: a. On or about March 18, 2014, employees worked side by side with the physician during surgical procedures and the employer did not solicit input from non-managerial employees in the identification, evaluation, and selection of better and/or effective engineering and work practice controls used at the center that could prevent injuries from contaminated sharps. |
| Citation ID | 02002 |
| Citaton Type | Other |
| Standard Cited | 19101030 F02 IV |
| Issuance Date | 2014-06-23 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2014-07-14 |
| Nr Instances | 1 |
| Nr Exposed | 3 |
| Related Event Code (REC) | Complaint |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(f)(2)(iv): The employer did not ensure that employees who declined to accept the hepatitis B vaccination offered by the employer signed the statement in appendix A: a. On or about March 29, 2014, the employers' Hepatitis B declination letter included in the new employee application package did not include the statement required under Appendix A of the 1910.1030 Bloodborne Pathogens standard. |
| Citation ID | 02003 |
| Citaton Type | Other |
| Standard Cited | 19101200 H01 |
| Issuance Date | 2014-06-23 |
| Abatement Due Date | 2014-07-18 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2014-07-14 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1200(h)(1): Employees were not provided effective information and training on hazardous chemicals in their work area at the time of their initial assignment and whenever a new hazard that the employees had not been previously trained about was introduced into their work area: a. On or about March 18, 2014, employees worked with or around hazardous chemicals such as, but not limited to, Cidex Plus and 10% Formalin solution and the employer did not provide effective information on the location of the employers' hazard communication program, the location of the safety data sheets, and the health hazards of the chemicals at the time of their initial assignment. |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5526728307 | 2021-01-25 | 0491 | PPS | 480 SW Main Blvd, Lake City, FL, 32025-5269 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6846177000 | 2020-04-07 | 0491 | PPP | 480 SW MAIN BLVD, LAKE CITY, FL, 32025-5269 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Apr 2025
Sources: Florida Department of State
