| Entity Name: | KEYES SURGICAL ASSIST, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 Jun 2005 (20 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P05000090732 |
| FEI/EIN Number | 203382414 |
| Address: | 132 WIDE RIVER COVE, STUART, FL, 34994 |
| Mail Address: | 132 WIDE RIVER COVE, STUART, FL, 34994 |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356494777 | 2007-01-19 | 2007-11-20 | 132 WIDE RIVER CV, STUART, FL, 349949132, US | 1700 S 23RD ST, FORT PIERCE, FL, 349504803, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 772-398-9763 |
| Fax | 7723377548 |
| Phone | +1 772-461-4000 |
| Fax | 7724672856 |
Authorized person
| Name | MR. JAMES MILLER KEYES |
| Role | PHYSICIAN ASSISTANT CERTIFIED |
| Phone | 7723989763 |
Taxonomy
| Taxonomy Code | 363AS0400X - Surgical Physician Assistant |
| License Number | PA2081 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | X1622 |
| State | FL |
| Issuer | MEDICARE RAILROAD |
| Number | DF1932 |
| State | FL |
| Issuer | METCARE |
| Number | 65113 |
| Name | Role | Address |
|---|---|---|
| KEYES JAMES | Agent | 132 WIDE RIVER COVE, STUART, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| KEYES JAMES | President | 132 WIDE RIVER COVE, STUART, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| KEYES JAMES | Director | 132 WIDE RIVER COVE, STUART, FL, 34994 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-01-13 |
| ANNUAL REPORT | 2009-04-21 |
| ANNUAL REPORT | 2008-01-29 |
| ANNUAL REPORT | 2007-01-16 |
| ANNUAL REPORT | 2006-04-17 |
| Domestic Profit | 2005-06-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
