| Entity Name: | VEIN SPECIALISTS, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Jul 2004 (21 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 23 Dec 2013 (11 years ago) |
| Document Number: | P04000104487 |
| FEI/EIN Number | 201737696 |
| Address: | 4371 Northlake Blvd, Box 129, Palm Beach Gardens, FL, 33410, US |
| Mail Address: | 4371 Northlake Blvd, Box 129, Palm Beach Gardens, FL, 33410, US |
| ZIP code: | 33410 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043406838 | 2007-09-14 | 2020-04-02 | 5155 CORPORATE WAY STE A, JUPITER, FL, 334584359, US | 5155 CORPORATE WAY STE A, JUPITER, FL, 334584359, US | |||||||||||||||||||
|
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| Phone | +1 561-624-0123 |
| Fax | 5616241453 |
Authorized person
| Name | DR. STEVEN M. TIDWELL |
| Role | PRESIDENT |
| Phone | 5616240123 |
Taxonomy
| Taxonomy Code | 2085R0204X - Vascular & Interventional Radiology Physician |
| License Number | ME 62477 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Tidwell Kyle | Agent | 4371 Northlake Blvd, Palm Beach Gardens, FL, 33410 |
| Name | Role | Address |
|---|---|---|
| TIDWELL STEVEN M | President | 4371 Northlake Blvd, Palm Beach Gardens, FL, 33410 |
| Name | Role | Address |
|---|---|---|
| TIDWELL JEANNE M | Secretary | 4371 Northlake Blvd, Palm Beach Gardens, FL, 33410 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-04-08 | Tidwell, Kyle | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-08 | 4371 Northlake Blvd, Box 129, Palm Beach Gardens, FL 33410 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-27 | 4371 Northlake Blvd, Box 129, Palm Beach Gardens, FL 33410 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-27 | 4371 Northlake Blvd, Box 129, Palm Beach Gardens, FL 33410 | No data |
| AMENDMENT | 2013-12-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| ANNUAL REPORT | 2023-03-27 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-03-03 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-02-22 |
| ANNUAL REPORT | 2017-03-16 |
| ANNUAL REPORT | 2016-03-22 |
| ANNUAL REPORT | 2015-04-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
