| Entity Name: | TREASURE COAST PULMONARY MEDICINE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 21 Oct 2016 (8 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P16000085073 |
| FEI/EIN Number | 81-4230369 |
| Address: | 10380 SW VILLAGE CENTER DRIVE, #319, PORT ST. LUCIE, FL, 34987, US |
| Mail Address: | 10380 SW VILLAGE CENTER DRIVE, #319, PORT ST. LUCIE, FL, 34987, US |
| ZIP code: | 34987 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871036236 | 2016-12-02 | 2016-12-02 | 10380 SW VILLAGE CENTER DR, 319, PORT ST LUCIE, FL, 349871931, US | 10380 SW VILLAGE CENTER DR, 319, PORT ST LUCIE, FL, 349871931, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 772-485-3695 |
Authorized person
| Name | DR. VIVEK KAUL |
| Role | PRESIDENT |
| Phone | 7724853695 |
Taxonomy
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| License Number | ME99553 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | ME99553 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207RS0012X - Sleep Medicine (Internal Medicine) Physician |
| License Number | ME99553 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| NORMAN KENNETH A | Agent | 2400 SE FEDERAL HIGHWAY, FOURTH FLOOR, STUART, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| Kaul, M.D. Vivek | President | 10380 SW VILLAGE CENTER DRIVE, #319, PORT ST. LUCIE, FL, 34987 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-11-28 | 10380 SW VILLAGE CENTER DRIVE, #319, PORT ST. LUCIE, FL 34987 | No data |
| CHANGE OF MAILING ADDRESS | 2016-11-28 | 10380 SW VILLAGE CENTER DRIVE, #319, PORT ST. LUCIE, FL 34987 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-04-19 |
| ANNUAL REPORT | 2017-04-17 |
| Domestic Profit | 2016-10-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
