| Entity Name: | A-1 MASTECTOMY CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Jan 2004 (21 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 10 Sep 2009 (15 years ago) |
| Document Number: | P04000021333 |
| FEI/EIN Number | 760750697 |
| Address: | 16608 SADDLE CLUB RD, WESTON, FL, 33326 |
| Mail Address: | 16608 SADDLE CLUB RD, WESTON, FL, 33326 |
| ZIP code: | 33326 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629063623 | 2005-09-15 | 2020-06-15 | 16608 SADDLE CLUB RD, WESTON, FL, 333261808, US | 16608 SADDLE CLUB RD, WESTON, FL, 333261808, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-515-0740 |
| Fax | 9545150260 |
Authorized person
| Name | MARIA A WISEMAN |
| Role | PRESIDENT |
| Phone | 9545150740 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AVMED DME PROVIDER |
| Number | 296732 |
| State | FL |
| Issuer | PREFERRED HEALTH PARTNERS |
| Number | 002X6 |
| State | FL |
| Issuer | NEIGHBORHOOD DME PROVIDE |
| Number | 0-50342 |
| State | FL |
| Issuer | AETNA PPO PROVIDER |
| Number | 7565570 |
| State | FL |
| Issuer | AETNA HMO PROVIDER |
| Number | 3647669 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD DM |
| Number | R9553 |
| State | FL |
| Issuer | WELLCARE DME PROVIDER |
| Number | 245123 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WISEMAN MARIA A | Agent | 16608 SADDLE CLUB RD, WESTON, FL, 33326 |
| Name | Role | Address |
|---|---|---|
| WISEMAN MARIA A | President | 12925 ANTHORNE LANE, BOYNTON BEACH, FL, 33436 |
| Name | Role | Address |
|---|---|---|
| WISEMAN MARIA A | Director | 12925 ANTHORNE LANE, BOYNTON BEACH, FL, 33436 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2009-09-10 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-07-05 | 16608 SADDLE CLUB RD, WESTON, FL 33326 | No data |
| CHANGE OF MAILING ADDRESS | 2005-07-05 | 16608 SADDLE CLUB RD, WESTON, FL 33326 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-07-05 | 16608 SADDLE CLUB RD, WESTON, FL 33326 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-23 |
| ANNUAL REPORT | 2024-01-16 |
| ANNUAL REPORT | 2023-02-15 |
| ANNUAL REPORT | 2022-01-18 |
| ANNUAL REPORT | 2021-02-17 |
| ANNUAL REPORT | 2020-01-22 |
| ANNUAL REPORT | 2019-02-25 |
| ANNUAL REPORT | 2018-02-07 |
| ANNUAL REPORT | 2017-01-27 |
| ANNUAL REPORT | 2016-01-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
