| Entity Name: | CAPITAL MEDICAL AND SURGICAL INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 05 Mar 2003 (22 years ago) |
| Document Number: | P03000026451 |
| FEI/EIN Number | 020681162 |
| Address: | 2028 NORTH POINT BLVD., TALLAHASSEE, FL, 32308, US |
| Mail Address: | 2028 NORTH POINT BLVD., TALLAHASSEE, FL, 32308, US |
| ZIP code: | 32308 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255380168 | 2006-05-08 | 2020-08-22 | 2744 CAPITAL CIR NE, TALLAHASSEE, FL, 323084108, US | 2744 CAPITAL CIR NE, TALLAHASSEE, FL, 323084108, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 850-942-0198 |
| Fax | 8019058591 |
Authorized person
| Name | MR. HOWARD KLINE MILLER |
| Role | V.P./OWNER |
| Phone | 8509420198 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 028459900 |
| State | FL |
| Issuer | BLUECROSS BLUE SHIELD |
| Number | R9539 |
| State | FL |
| Issuer | MEDICAID |
| Number | 974544199A |
| State | GA |
| Name | Role | Address |
|---|---|---|
| Chung Jae H | Agent | 9309 Old Kings Rd S, Jacksonville, FL, 32257 |
| Name | Role | Address |
|---|---|---|
| MILLER KLINE | Vice President | 2028 NORTH POINT BLVD., TALLAHASSEE, FL, 32308 |
| Chung Hyon S | Vice President | 9309 Old Kings Rd S, Jacksonville, FL, 32257 |
| Name | Role | Address |
|---|---|---|
| Chung Jae H | Director | 9309 Old Kings Rd S, Jacksonville, FL, 32257 |
| Name | Role | Address |
|---|---|---|
| Chung Hyon J | Secretary | 9309 old kings rd south, Jacksonville, FL, 32257 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-09-03 | 2028 NORTH POINT BLVD., TALLAHASSEE, FL 32308 | No data |
| CHANGE OF MAILING ADDRESS | 2024-09-03 | 2028 NORTH POINT BLVD., TALLAHASSEE, FL 32308 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-01-12 | 9309 Old Kings Rd S, Suite 4, Jacksonville, FL 32257 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-02-12 | Chung, Jae H | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J14000790351 | LAPSED | 2014-CA-000288 | LEON COUNTY CIRCUIT COURT | 2014-07-17 | 2019-07-18 | $57,470.57 | BRANCH BANKING AND TRUST COMPANY, 200 WEST SECOND STREET, WINSTON-SALEM, NC 27101 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-02-03 |
| AMENDED ANNUAL REPORT | 2020-10-12 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-12 |
| ANNUAL REPORT | 2017-01-05 |
| ANNUAL REPORT | 2016-03-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
