| Entity Name: | PLASTIC SURGERY OF JUPITER, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Jul 1998 (27 years ago) |
| Document Number: | P98000064733 |
| FEI/EIN Number | 650852403 |
| Address: | 4600 MILITARY TRAIL, SUITE 202, JUPITER, FL, 33458 |
| Mail Address: | 4600 MILITARY TRAIL, SUITE 202, JUPITER, FL, 33458 |
| ZIP code: | 33458 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134356991 | 2009-06-18 | 2009-07-09 | 4600 MILITARY TRL, SUITE 202, JUPITER, FL, 334584810, US | 4600 MILITARY TRL, SUITE 202, JUPITER, FL, 334584810, US | |||||||||||||||||||
|
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| Phone | +1 561-748-1565 |
| Fax | 5617481568 |
Authorized person
| Name | KIM EDWARD KOGER |
| Role | MEDICAL DIRECTOR |
| Phone | 5617481565 |
Taxonomy
| Taxonomy Code | 171000000X - Military Health Care Provider |
| License Number | ME75895 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KOGER KIM E | Agent | 4600 MILITARY TRAIL, JUPITER, FL, 33458 |
| Name | Role | Address |
|---|---|---|
| KOGER KIM E | Manager | 4600 MILITARY TRAIL , SUITE 202, JUPITER, FL, 33458 |
| Name | Role | Address |
|---|---|---|
| KOGER KIM E | Director | 4600 MILITARY TRAIL , SUITE 202, JUPITER, FL, 33458 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000018899 | KOGER COSMETIC CLINIC & MEDSPA | ACTIVE | 2020-02-11 | 2025-12-31 | No data | 4600 MILITARY TRAIL, SUITE 202, JUPITER, FL, 33458 |
| G08346900016 | KOGER COSMETIC CLINIC & MEDSPA | EXPIRED | 2008-12-09 | 2013-12-31 | No data | 4600 MILITARY TRAIL, SUITE 202, JUPITER, FL, 33458 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
