| Entity Name: | FLORIDA KEYS ORTHOPEDIC AND SPORTS MEDICINE CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 Jan 1996 (29 years ago) |
| Document Number: | P96000005079 |
| FEI/EIN Number | 650630900 |
| Address: | 100210 OVERSEAS HWY, SUITE 3, KEY LARGO, FL, 33037, US |
| Mail Address: | 100210 OVERSEAS HWY, SUITE 3, KEY LARGO, FL, 33037, US |
| ZIP code: | 33037 |
| County: | Monroe |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760430987 | 2006-05-04 | 2022-03-01 | 100210 OVERSEAS HWY, STE 3, KEY LARGO, FL, 330372527, US | 100210 OVERSEAS HWY, STE 3, KEY LARGO, FL, 330372527, US | |||||||||||||||||||||
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| Phone | +1 305-453-3633 |
| Fax | 3054533637 |
Authorized person
| Name | PAUL S ELLISON JR. |
| Role | PRESIDENT |
| Phone | 3054533633 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 379646900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ELLISON PAUL S | Agent | 92165 OVERSEAS HWY, TAVERNIER, FL, 33070 |
| Name | Role | Address |
|---|---|---|
| ELLISON PAUL S | President | 100210 OVERSEAS HWY SUITE 3, KEY LARGO, FL, 33037 |
| Name | Role | Address |
|---|---|---|
| ELLISON PAUL S | Secretary | 100210 OVERSEAS HWY SUITE 3, KEY LARGO, FL, 33037 |
| Name | Role | Address |
|---|---|---|
| ELLISON PAUL S | Treasurer | 100210 OVERSEAS HWY SUITE 3, KEY LARGO, FL, 33037 |
| Name | Role | Address |
|---|---|---|
| ELLISON PAUL S | Director | 100210 OVERSEAS HWY SUITE 3, KEY LARGO, FL, 33037 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2006-04-17 | 100210 OVERSEAS HWY, SUITE 3, KEY LARGO, FL 33037 | No data |
| CHANGE OF MAILING ADDRESS | 2006-04-17 | 100210 OVERSEAS HWY, SUITE 3, KEY LARGO, FL 33037 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2002-02-07 | 92165 OVERSEAS HWY, TAVERNIER, FL 33070 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-12 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-03-16 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-03-19 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-24 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-13 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
