| Entity Name: | TREASURE COAST SURGERY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 02 Aug 1996 (29 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 03 Jul 2000 (25 years ago) |
| Document Number: | P96000064808 |
| FEI/EIN Number | 650682125 |
| Address: | 1155 SE MONTEREY ROAD EXT, STUART, FL, 34994, US |
| Mail Address: | 1050 SE MONTEREY ROAD, Suite 400, STUART, FL, 34994, US |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730112129 | 2006-07-08 | 2020-08-22 | 1411 SE OCEAN BLVD, STUART, FL, 349962651, US | 1411 SE OCEAN BLVD, STUART, FL, 349962651, US | |||||||||||||||||||||||||
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| Phone | +1 772-286-8028 |
| Fax | 7722836628 |
Authorized person
| Name | MRS. ANDREA L DAY |
| Role | BUSINESS OFFICE MANAGER |
| Phone | 7722869656 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 1002 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS/BLUE SHIELD |
| Number | 66A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CARLSON WILLIAM M | Agent | 1050 SE MONTEREY RD, STUART, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| CARLSON WILLIAM M | Manager | 1050 SE MONTEREY RD STE 400, STUART, FL, 34994 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2019-04-23 | 1155 SE MONTEREY ROAD EXT, STUART, FL 34994 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-02-11 | 1155 SE MONTEREY ROAD EXT, STUART, FL 34994 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-03-05 | CARLSON, WILLIAM MD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-03-05 | 1050 SE MONTEREY RD, STE 400, STUART, FL 34994 | No data |
| AMENDMENT | 2000-07-03 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-11 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-03-25 |
| ANNUAL REPORT | 2021-04-02 |
| ANNUAL REPORT | 2020-03-04 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-01-20 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-19 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
