| Entity Name: | JUPITER WEST MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 08 Oct 1996 (28 years ago) |
| Document Number: | P96000082701 |
| FEI/EIN Number | 65-0706681 |
| Mail Address: | PO BOX 2755, JUPITER, FL 33468 |
| Address: | 2632 W. INDIANTOWN ROAD, JUPITER, FL 33458 |
| ZIP code: | 33458 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497415053 | 2021-12-23 | 2022-08-18 | 2632 W INDIANTOWN RD, JUPITER, FL, 334585889, US | 10377 S US HIGHWAY 1 STE 101, PORT ST LUCIE, FL, 349525630, US | |||||||||||||||||||||||
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| Phone | +1 561-744-7373 |
| Fax | 8007835176 |
| Phone | +1 772-337-1300 |
Authorized person
| Name | ELAINE OSWALD |
| Role | CREDENTIALING SPECIALIST |
| Phone | 5612363741 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000647406 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PAPA, MICHAEL DR. | Agent | 1124 San Michele Way, Palm Beach Gardens, FL 33418 |
| Name | Role | Address |
|---|---|---|
| PAPA, MICHAEL | President | 1124 San Michele Way, Palm Beach Gardens, FL 33418 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-30 | 2632 W. INDIANTOWN ROAD, JUPITER, FL 33458 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-30 | 2632 W. INDIANTOWN ROAD, JUPITER, FL 33458 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-01-29 | 1124 San Michele Way, Palm Beach Gardens, FL 33418 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-29 |
| ANNUAL REPORT | 2023-03-07 |
| ANNUAL REPORT | 2022-01-18 |
| ANNUAL REPORT | 2021-02-03 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-03-06 |
| ANNUAL REPORT | 2018-02-01 |
| ANNUAL REPORT | 2017-01-16 |
| ANNUAL REPORT | 2016-02-01 |
| ANNUAL REPORT | 2015-01-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
