| Entity Name: | SUNRISE PRIMARY CARE INC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
SUNRISE PRIMARY CARE INC 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: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 30 Jul 2001 (24 years ago) |
| Date of dissolution: | 27 Sep 2019 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (6 years ago) |
| Document Number: | P01000075664 |
| FEI/EIN Number |
593736354
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 100 ARRICOLA AVE, ST. AUGUSTINE, FL, 32080, US |
| Mail Address: | 100 ARRICOLA AVE, ST. AUGUSTINE, FL, 32080, US |
| ZIP code: | 32080 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124294012 | 2008-05-01 | 2008-05-01 | PO BOX 249, PALATKA, FL, 321780249, US | 811 N SUMMIT ST, CRESCENT CITY, FL, 321122109, US | |||||||||||||||||||||||||
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| Phone | +1 386-698-2279 |
| Fax | 3866982239 |
Authorized person
| Name | ALBINO GAW |
| Role | ADMINISTRATOR |
| Phone | 3866982279 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME076342 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 660181201 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUNRISE PRIMARY CARE 401(K) TRUST | 2018 | 593736354 | 2019-09-16 | SUNRISE PRIMARY CARE | 14 | |||||||||||||||||||||||||||||||
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| SUNRISE PRIMARY CARE 401(K) TRUST | 2017 | 593736354 | 2018-04-06 | SUNRISE PRIMARY CARE | 16 | |||||||||||||||||||||||||||||||
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| SUNRISE PRIMARY CARE 401(K) TRUST | 2016 | 593736354 | 2017-07-06 | SUNRISE PRIMARY CARE | 13 | |||||||||||||||||||||||||||||||
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| SUNRISE PRIMARY CARE 401(K) TRUST | 2015 | 593736354 | 2016-09-08 | SUNRISE PRIMARY CARE | 12 | |||||||||||||||||||||||||||||||
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| SUNRISE PRIMARY CARE 401(K) TRUST | 2014 | 593736354 | 2015-07-06 | SUNRISE PRIMARY CARE | 15 | |||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2015-07-06 |
| Name of individual signing | ALBINO GAW |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3866982279 |
| Plan sponsor’s address | 811 N SUMMIT ST, CRESCENT CITY, FL, 32112 |
Signature of
| Role | Plan administrator |
| Date | 2014-09-15 |
| Name of individual signing | ALBINO GAW |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3866982279 |
| Plan sponsor’s address | 811 N SUMMIT ST, CRESCENT CITY, FL, 32112 |
Signature of
| Role | Plan administrator |
| Date | 2013-06-21 |
| Name of individual signing | ALBINO GAW |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3866982279 |
| Plan sponsor’s address | 811 N SUMMIT ST, CRESCENT CITY, FL, 32112 |
Plan administrator’s name and address
| Administrator’s EIN | 593736354 |
| Plan administrator’s name | SUNRISE PRIMARY CARE |
| Plan administrator’s address | 811 N SUMMIT ST, CRESCENT CITY, FL, 32112 |
| Administrator’s telephone number | 3866982279 |
Signature of
| Role | Plan administrator |
| Date | 2012-06-18 |
| Name of individual signing | ALBINO GAW |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3866982279 |
| Plan sponsor’s address | 811 N SUMMIT ST, CRESCENT CITY, FL, 32112 |
Plan administrator’s name and address
| Administrator’s EIN | 593736354 |
| Plan administrator’s name | SUNRISE PRIMARY CARE |
| Plan administrator’s address | 811 N SUMMIT ST, CRESCENT CITY, FL, 32112 |
| Administrator’s telephone number | 3866982279 |
Signature of
| Role | Plan administrator |
| Date | 2011-09-07 |
| Name of individual signing | ALBINO GAW |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3866982279 |
| Plan sponsor’s address | 811 N SUMMIT ST, CRESCENT CITY, FL, 32112 |
Plan administrator’s name and address
| Administrator’s EIN | 593736354 |
| Plan administrator’s name | SUNRISE PRIMARY CARE |
| Plan administrator’s address | 811 N SUMMIT ST, CRESCENT CITY, FL, 32112 |
| Administrator’s telephone number | 3866982279 |
Signature of
| Role | Employer/plan sponsor |
| Date | 2010-10-21 |
| Name of individual signing | MARIA-JOSEFINA S. RIVERA GAW |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| GAW ALBINO | Secretary | 108 N. Bartram Trail, San Mateo, FL, 32187 |
| HINMAN ROY HII, MD | President | 100 ARRICOLA AVE, ST. AUGUSTINE, FL, 32080 |
| CULVER DAVE | Agent | 100 ARRICOLA AVE, ST. AUGUSTINE, FL, 32080 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | - | - |
| AMENDMENT | 2019-01-30 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2019-01-30 | 100 ARRICOLA AVE, ST. AUGUSTINE, FL 32080 | - |
| CHANGE OF MAILING ADDRESS | 2019-01-30 | 100 ARRICOLA AVE, ST. AUGUSTINE, FL 32080 | - |
| REGISTERED AGENT NAME CHANGED | 2019-01-30 | CULVER, DAVE | - |
| REGISTERED AGENT ADDRESS CHANGED | 2019-01-30 | 100 ARRICOLA AVE, ST. AUGUSTINE, FL 32080 | - |
| Name | Date |
|---|---|
| Amendment | 2019-01-30 |
| ANNUAL REPORT | 2018-03-14 |
| ANNUAL REPORT | 2017-03-15 |
| ANNUAL REPORT | 2016-01-17 |
| ANNUAL REPORT | 2015-03-25 |
| ANNUAL REPORT | 2014-03-31 |
| ANNUAL REPORT | 2013-03-04 |
| ANNUAL REPORT | 2012-02-10 |
| ANNUAL REPORT | 2011-02-18 |
| ANNUAL REPORT | 2010-02-24 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 339305567 | 0419700 | 2013-08-14 | 219 N PALM AVE, PALATKA, FL, 32178 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Type | Complaint |
| Activity Nr | 836780 |
| Health | Yes |
Violation Items
| Citation ID | 01001 |
| Citaton Type | Serious |
| Standard Cited | 19101030 D02 I |
| Issuance Date | 2013-10-22 |
| Abatement Due Date | 2013-12-10 |
| Current Penalty | 2244.0 |
| Initial Penalty | 2244.0 |
| Final Order | 2013-11-15 |
| Nr Instances | 1 |
| Nr Exposed | 4 |
| Gravity | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(d)(2)(i): Engineering and work practice controls were not used to eliminate or minimize employees exposure: a. On or about August 16, 2013, engineering controls such as, but not limited to, needles with engineering protection vacutainers with safety lock, and retractable scalples were not used to guard against employee exposure to needles and scalples potentially contaminated with bloodborne pathogens when drawing blood or giving assisting the physician durin biopsies. |
| Citation ID | 01002 |
| Citaton Type | Serious |
| Standard Cited | 19101030 F01 II D |
| Issuance Date | 2013-10-22 |
| Abatement Due Date | 2013-11-18 |
| Current Penalty | 2244.0 |
| Initial Penalty | 2244.0 |
| Final Order | 2013-11-15 |
| Nr Instances | 1 |
| Nr Exposed | 1 |
| Gravity | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(f)(1)(ii)(D): The employer did not ensure that all medical evaluations or procedures including the hepatitis B vaccine, vaccination series, post-exposure evaluation, or follow-up, including prophylaxis, were provided according to recommendations of the US. Public Health Service current at the time these evaluations and procedure took place: a. On or about August 16, 2013, an employee that accepted the Hepatitis B vaccine was not provided with the shot series as recommended by the US Public Health Service in that the third dose was not administered within six months following the previous shot. |
| Citation ID | 02001 |
| Citaton Type | Other |
| Standard Cited | 19101048 D01 I |
| Issuance Date | 2013-10-22 |
| Abatement Due Date | 2013-12-10 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2013-11-15 |
| Nr Instances | 1 |
| Nr Exposed | 4 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1048(d)(1)(i): Employees of a workplace covered by this standard were not monitored to determine their exposure to formaldehyde: a. On or about August 16, 2013, employees used containers pre-filled with a solution of 10% Formalin to preserve human tissue extracted from biopsies and the employer have not conducted an initial monitoring to determine their exposure to formaldehyde. |
| Citation ID | 02002 |
| Citaton Type | Other |
| Standard Cited | 19101048 M01 III |
| Issuance Date | 2013-10-22 |
| Abatement Due Date | 2013-12-10 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2013-11-15 |
| Nr Instances | 1 |
| Nr Exposed | 4 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1048(m)(1)(iii): The employers did not include formaldehyde in the hazard communication program established to comply with the HCS (� 1910.1200). Employers did not ensure that each employee had access to labels on containers of formaldehyde and to safety data sheets, and was trained in accordance with the requirements of HCS and paragraph (n) of this section: a. On or about August 16, 2013, employees used a container pre-filled with a 10% formalin solution to preserve human tissue extracted during biopsies and the employer did not provide training on the health hazards associated to handling of formaldehyde and did not include formaldehyde in their hazard communication program or training program. |
| Inspection Type | Planned |
| Scope | Partial |
| Safety/Health | Health |
| Close Conference | 2013-01-08 |
| Emphasis | P: SHARPS, L: SHARPS |
| Case Closed | 2013-01-31 |
| Inspection Type | Planned |
| Scope | Complete |
| Safety/Health | Health |
| Close Conference | 2012-10-04 |
| Emphasis | L: EISAOF, L: SHARPS |
| Case Closed | 2013-01-31 |
Violation Items
| Citation ID | 01001 |
| Citaton Type | Serious |
| Standard Cited | 19101030 G02 VII |
| Issuance Date | 2012-11-30 |
| Abatement Due Date | 2013-01-18 |
| Current Penalty | 1360.0 |
| Initial Penalty | 1360.0 |
| Final Order | 2013-01-02 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| 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 September 6, 2012, the bloodborne pathogens annual training did not contain the minimum elements outlined in 29 CFR 1910.1030(g)(2)(vii)(A)-(N), such as, but not limited to: 1. An explanation of the employer's exposure control plan and the means by which the employee can obtain a copy of the written plan. 2. 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. 3. A format that offered interactive questions or answers during the training session at the facility. |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
