| Entity Name: | SURGICAL SERVICES OF FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Jan 2003 (22 years ago) |
| Document Number: | P03000004577 |
| FEI/EIN Number | 043735278 |
| Address: | 3845 SW 148 terrace, MIRAMAR, FL, 33027, US |
| Mail Address: | P.O. BOX 527432, MIAMI, FL, 33152 |
| ZIP code: | 33027 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043413727 | 2007-06-08 | 2012-02-03 | PO BOX 527432, MIAMI, FL, 331527432, US | 11341 NW 42ND TER, DORAL, FL, 331781810, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 305-761-9392 |
| Fax | 3053810548 |
Authorized person
| Name | CARLOS A BLANCO |
| Role | PRESIDENT |
| Phone | 3057619392 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME 71266 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 250957100 |
| State | FL |
| Issuer | INDIVIDUAL NPI |
| Number | 1699716670 |
| State | FL |
| Issuer | MEDICAID |
| Number | 266547600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BLANCO CARLOS A | Agent | P.O. BOX 527432, MIAMI, FL, 33152 |
| Name | Role | Address |
|---|---|---|
| BLANCO CARLOS Dr. | President | P.O. BOX 527432, MIAMI, FL, 33152 |
| BLANCO CARLOS A | President | P.O. BOX 527432, MIAMI, FL, 33152 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-29 | 3845 SW 148 terrace, MIRAMAR, FL 33027 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-01-28 | P.O. BOX 527432, MIAMI, FL 33152 | No data |
| CHANGE OF MAILING ADDRESS | 2008-04-12 | 3845 SW 148 terrace, MIRAMAR, FL 33027 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-27 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-03-29 |
| ANNUAL REPORT | 2019-02-09 |
| ANNUAL REPORT | 2018-01-12 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-01-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
