| Entity Name: | ATLANTIC SURGERY CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 19 Sep 1994 (30 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 08 Nov 2022 (2 years ago) |
| Document Number: | P94000068901 |
| FEI/EIN Number | 59-3282460 |
| Address: | 541 HEALTH BLVD, DAYTONA BEACH, FL 32114 |
| Mail Address: | 541 HEALTH BLVD, DAYTONA BEACH, FL 32114 |
| ZIP code: | 32114 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518976661 | 2006-08-07 | 2017-05-11 | 541 HEALTH BLVD, DAYTONA BEACH, FL, 321141493, US | 541 HEALTH BLVD, DAYTONA BEACH, FL, 321141493, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 386-239-0021 |
| Fax | 3862488226 |
Authorized person
| Name | ANTHONY L CANTWELL |
| Role | PRESIDENT |
| Phone | 3862390021 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | 1020 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | UNITED MINE WORKERS |
| Number | 1495361 |
| State | FL |
| Issuer | MEDICAID |
| Number | 006574700 |
| State | FL |
| Issuer | BLUE CROSS AND BLUE SHIEL |
| Number | 64J |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Anthony Cantwell, MD | Agent | 541 HEALTH BLVD., DAYTONA BEACH, FL 32114 |
| Name | Role | Address |
|---|---|---|
| Cantwell, Anthony, Dr. | President | 541 HEALTH BLVD, DAYTONA BEACH, FL 32114 |
| Name | Role | Address |
|---|---|---|
| Lawindy, Samuel MD | Secretary | 541 HEALTH BLVD, DAYTONA BEACH, FL 32114 |
| Name | Role | Address |
|---|---|---|
| Lawindy, Samuel MD | Treasurer | 541 HEALTH BLVD, DAYTONA BEACH, FL 32114 |
| Name | Role | Address |
|---|---|---|
| NICOLAI, Jeffrey W | Administrator | 541 HEALTH BLVD, DAYTONA BEACH, FL 32114 |
| Name | Role | Address |
|---|---|---|
| DeCarli, Antonio, Dr. | P. | 541 HEALTH BLVD, DAYTONA BEACH, FL 32114 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-11-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REINSTATEMENT | 2021-08-26 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-01-23 | Anthony Cantwell, MD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-04-03 | 541 HEALTH BLVD., DAYTONA BEACH, FL 32114 | No data |
| AMENDMENT | 1999-05-04 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-03-08 |
| REINSTATEMENT | 2022-11-08 |
| REINSTATEMENT | 2021-08-26 |
| ANNUAL REPORT | 2019-03-25 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-02-15 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-02-18 |
| ANNUAL REPORT | 2014-04-24 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 338224223 | 0419700 | 2013-01-07 | 541 HEALTH BLVD, DAYTONA BEACH, FL, 32114 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Type | Inspection |
| Activity Nr | 608018 |
| Health | Yes |
| Inspection Type | Planned |
| Scope | Complete |
| Safety/Health | Health |
| Close Conference | 2012-08-30 |
| Emphasis | L: EISAOF, L: SHARPS |
| Case Closed | 2013-09-24 |
Violation Items
| Citation ID | 01001 |
| Citaton Type | Serious |
| Standard Cited | 19100242 B |
| Issuance Date | 2012-09-07 |
| Abatement Due Date | 2012-09-14 |
| Current Penalty | 1071.0 |
| Initial Penalty | 1785.0 |
| Final Order | 2013-09-24 |
| Nr Instances | 1 |
| Nr Exposed | 6 |
| Gravity | 1 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.242(b): Compressed air used for cleaning purposes was not reduced to less than 30 p.s.i.: a. On or about August 30, 2012, in the sterilization room, surgical technicians used compressed air that blew approximately 57 p.s.i. to remove water from surgical instruments. |
| Citation ID | 01002 |
| Citaton Type | Serious |
| Standard Cited | 19101030 D02 I |
| Issuance Date | 2012-09-07 |
| Abatement Due Date | 2012-09-28 |
| Current Penalty | 1785.0 |
| Initial Penalty | 2975.0 |
| Final Order | 2013-09-24 |
| Nr Instances | 2 |
| Nr Exposed | 10 |
| Gravity | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(d)(2)(i): Engineering and work practice controls were not used to eliminate or minimize employees exposure: a. On or about August 30, 2012, engineering controls such as, but not limited to, needles with engineering protection were not used to guard against employee exposure to needles potentially contaminated with bloodborne pathogens when giving injections. b. On or about August 30, 2012, engineering controls such as, but not limited to, needles with engineering protection were not used to guard against employee exposure to needles potentially contaminated with bloodborne pathogens when retrieving them following medical procedures. |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
