| Entity Name: | WATERS EDGE SURGERY CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 14 Aug 1996 (28 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P96000067609 |
| FEI/EIN Number | 650686875 |
| Address: | 201 S.E. OSCEOLA ST, STUART, FL, 34994 |
| Mail Address: | 201 S.E. OSCEOLA ST, STUART, FL, 34994 |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447209358 | 2006-05-08 | 2023-03-07 | 201 SE OSCEOLA ST, STUART, FL, 349942210, US | 201 SE OSCEOLA ST, STUART, FL, 349942210, US | |||||||||||||||||||||||||
|
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| Phone | +1 772-286-9000 |
| Fax | 7722204077 |
Authorized person
| Name | ROBERT NATHAN COOPER |
| Role | PRESIDENT/MEDICAL DIRECTOR |
| Phone | 7722869000 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | PH20803 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FL LICENSE |
| Number | PH20803 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| COOPER ROBERT N | Agent | 201 S.E. OSCEOLA ST, STUART, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| COOPER ROBERT N | President | 201 S.E. OSCEOLA ST, STUART, FL, 34994 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-04-30 | 201 S.E. OSCEOLA ST, STUART, FL 34994 | No data |
| CHANGE OF MAILING ADDRESS | 2004-04-30 | 201 S.E. OSCEOLA ST, STUART, FL 34994 | No data |
| REGISTERED AGENT NAME CHANGED | 2004-04-30 | COOPER, ROBERT NM.D. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-04-30 | 201 S.E. OSCEOLA ST, STUART, FL 34994 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-01-25 |
| ANNUAL REPORT | 2010-03-04 |
| ANNUAL REPORT | 2009-04-22 |
| ANNUAL REPORT | 2008-04-23 |
| ANNUAL REPORT | 2007-04-30 |
| ANNUAL REPORT | 2006-04-28 |
| ANNUAL REPORT | 2005-04-26 |
| ANNUAL REPORT | 2004-04-30 |
| ANNUAL REPORT | 2003-03-05 |
| ANNUAL REPORT | 2002-05-24 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
