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  5. PRIMARY CARE OF THE TREASURE COAST, INC.

PRIMARY CARE OF THE TREASURE COAST, INC.

Company Details

Entity Name: PRIMARY CARE OF THE TREASURE COAST, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 17 Dec 1993 (31 years ago)
Document Number: P93000087288
FEI/EIN Number 650457414
Address: 3659 1st St SW, VERO BEACH, FL, 32968, US
Mail Address: 3659 1st St SW, VERO BEACH, FL, 32968, US
ZIP code: 32968
County: Indian River
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1598970618 2007-05-11 2010-03-01 PO BOX 1209, VERO BEACH, FL, 329611209, US 1265 36TH ST, VERO BEACH, FL, 329606574, US

Contacts
Phone +1 772-567-6340
Fax 7725676788

Authorized person
Name MR. JACK MICHAEL LUTON
Role CEO
Phone 7725676340

Taxonomy
Taxonomy Code 291U00000X - Clinical Medical Laboratory
License Number 800006678
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 375002700
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PRIMARY CARE OF THE TREASURE COAST 401(K) PROFIT SHARING PLAN 2022 650457414 2023-10-11 PRIMARY CARE OF THE TREASURE COAST, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7725676340
Plan sponsor’s address 1265 36TH ST, VERO BEACH, FL, 329606574

Signature of
Role Plan administrator
Date 2023-10-11
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-11
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF THE TREASURE COAST 401(K) PROFIT SHARING PLAN 2022 650457414 2023-10-10 PRIMARY CARE OF THE TREASURE COAST, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7725676340
Plan sponsor’s address 1265 36TH ST, VERO BEACH, FL, 329606574

Signature of
Role Plan administrator
Date 2023-10-10
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-10
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF THE TREASURE COAST 401(K) PROFIT SHARING PLAN 2021 650457414 2022-04-06 PRIMARY CARE OF THE TREASURE COAST, INC. 96
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7725676340
Plan sponsor’s address 1265 36TH ST, VERO BEACH, FL, 329606574

Signature of
Role Plan administrator
Date 2022-04-06
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-04-06
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF THE TREASURE COAST 401(K) PROFIT SHARING PLAN 2020 650457414 2021-04-07 PRIMARY CARE OF THE TREASURE COAST, INC. 97
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7725676340
Plan sponsor’s address 1265 36TH ST, VERO BEACH, FL, 329606574

Signature of
Role Plan administrator
Date 2021-04-07
Name of individual signing J.MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-07
Name of individual signing J.MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF THE TREASURE COAST 401(K) PROFIT SHARING PLAN 2019 650457414 2020-02-17 PRIMARY CARE OF THE TREASURE COAST, INC. 89
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7725676340
Plan sponsor’s address 1265 36TH ST, VERO BEACH, FL, 329606574

Signature of
Role Plan administrator
Date 2020-02-17
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-02-17
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF THE TREASURE COAST 401(K) PROFIT SHARING PLAN 2018 650457414 2019-02-19 PRIMARY CARE OF THE TREASURE COAST, INC. 78
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7725676340
Plan sponsor’s address 1265 36TH ST, VERO BEACH, FL, 329606574

Signature of
Role Plan administrator
Date 2019-02-19
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-02-19
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF THE TREASURE COAST 401(K) PROFIT SHARING PLAN 2017 650457414 2018-03-09 PRIMARY CARE OF THE TREASURE COAST, INC. 90
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7725676340
Plan sponsor’s address 1265 36TH ST, VERO BEACH, FL, 329606574

Signature of
Role Plan administrator
Date 2018-03-09
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-03-09
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF THE TREASURE COAST 401(K) PROFIT SHARING PLAN 2016 650457414 2017-03-13 PRIMARY CARE OF THE TREASURE COAST, INC. 80
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7725676340
Plan sponsor’s address 1265 36TH ST, VERO BEACH, FL, 329606574

Signature of
Role Plan administrator
Date 2017-03-13
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-03-13
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF THE TREASURE COAST 401(K) PROFIT SHARING PLAN 2015 650457414 2016-04-12 PRIMARY CARE OF THE TREASURE COAST, INC. 77
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7725676340
Plan sponsor’s address 1265 36TH ST, VERO BEACH, FL, 329606574

Signature of
Role Plan administrator
Date 2016-04-12
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-04-12
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF THE TREASURE COAST 401(K) PROFIT SHARING PLAN 2014 650457414 2015-04-08 PRIMARY CARE OF THE TREASURE COAST, INC. 71
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7725676340
Plan sponsor’s address 1265 36TH ST, VERO BEACH, FL, 329606574

Signature of
Role Plan administrator
Date 2015-04-08
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-08
Name of individual signing MICHAEL LUTON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ULRICH GUY Agent 3659 1st St SW, VERO BEACH, FL, 32968

President

Name Role Address
ULRICH GUY R President 3659 1st St SW, VERO BEACH, FL, 32968

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G11000016849 DOCTORS CHOICE PHARMACY EXPIRED 2011-02-14 2016-12-31 No data 1265 36TH ST., VERO BEACH, FL, 32960

Events

Event Type Filed Date Value Description
REINSTATEMENT 2023-10-10 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2023-09-22 No data No data

Related by officers

ULRICH GUY R

P.C.T.C. BUILDING COMPANY, INC.

Related by address

No related companies by address

Date of last update: 03 Jan 2025

Sources: Florida Department of State

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