| Entity Name: | FIRST COAST SURGICAL ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Apr 2005 (20 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 30 Oct 2024 (3 months ago) |
| Document Number: | P05000063799 |
| FEI/EIN Number | 550893915 |
| Address: | 6067 KENNERLY RD, JACKSONVILLE, FL, 32216 |
| Mail Address: | 6067 KENNERLY RD, JACKSONVILLE, FL, 32216 |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548249543 | 2006-01-10 | 2024-02-06 | 6067 KENNERLY RD, JACKSONVILLE, FL, 322164305, US | 6067 KENNERLY RD, JACKSONVILLE, FL, 322164305, US | |||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 904-731-3131 |
Authorized person
| Name | DR. BASSAM RIZK |
| Role | PRESIDENT |
| Phone | 9047313131 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| Is Primary | No |
| Taxonomy Code | 207RS0012X - Sleep Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 2084N0400X - Neurology Physician |
| Is Primary | No |
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | Yes |
| Taxonomy Code | 208C00000X - Colon & Rectal Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| RIZK BASSAM G | Agent | 6067 KENNERLY RD, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| RIZK BASSAM G | President | 6067 KENNERLY RD, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| RIZK BASSAM G | Secretary | 6067 KENNERLY RD, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| RIZK BASSAM G | Director | 6067 KENNERLY RD, JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| RIZK RALPH | Authorized Member | 6067 KENNERLY RD, JACKSONVILLE, FL, 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2024-10-30 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-02-19 | 6067 KENNERLY RD, JACKSONVILLE, FL 32216 | No data |
| CHANGE OF MAILING ADDRESS | 2009-02-19 | 6067 KENNERLY RD, JACKSONVILLE, FL 32216 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-02-19 | 6067 KENNERLY RD, JACKSONVILLE, FL 32216 | No data |
| AMENDMENT | 2008-07-28 | No data | No data |
| Name | Date |
|---|---|
| AMENDMENT | 2024-10-30 |
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-03-15 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-25 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-01-25 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
