| Entity Name: | SUNTREE MEDICAL ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 06 Jan 1997 (28 years ago) |
| Document Number: | P97000000951 |
| FEI/EIN Number | 593424634 |
| Address: | 6420 3RD STREET, STE 104, ROCKLEDGE, FL, 32955 |
| Mail Address: | 6420 3RD STREET, STE 104, ROCKLEDGE, FL, 32955 |
| ZIP code: | 32955 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265620744 | 2007-10-09 | 2007-10-09 | 6420 3RD ST, SUITE 104, ROCKLEDGE, FL, 329555788, US | 6420 3RD ST, SUITE 104, ROCKLEDGE, FL, 329555788, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 321-757-9711 |
| Fax | 3212531675 |
Authorized person
| Name | DR. CARL DOMINIC SALADINO |
| Role | OWNER/PRESIDENT |
| Phone | 3217579711 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME 55132 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KANCILIA JOHN R | Agent | 2101 Waverly Place, MELBOURNE, FL, 32901 |
| Name | Role | Address |
|---|---|---|
| SALADINO CARL M | Secretary | 7085 S. TROPICAL TRAIL, MERRITT ISLAND, FL, 32952 |
| Name | Role | Address |
|---|---|---|
| SALADINO CARL M | Treasurer | 7085 S. TROPICAL TRAIL, MERRITT ISLAND, FL, 32952 |
| Name | Role | Address |
|---|---|---|
| SALADINO CARL M | President | 7085 S. TROPICAL TRAIL, MERRITT ISLAND, FL, 32952 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
