| Entity Name: | PETER G. WERNICKI, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
PETER G. WERNICKI, M.D., P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 22 Jul 1999 (26 years ago) |
| Document Number: | P99000064996 |
| FEI/EIN Number |
650938033
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 787 37TH Street,, VERO BEACH, FL, 32960, US |
| Mail Address: | 787 37TH Street,, VERO BEACH, FL, 32960, US |
| ZIP code: | 32960 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063441731 | 2006-07-03 | 2022-08-10 | 787 37TH ST STE E200, VERO BEACH, FL, 329607306, US | 787 37TH ST STE E200, VERO BEACH, FL, 329607306, US | |||||||||||||||||||||||||||
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| Phone | +1 772-978-7808 |
| Fax | 7729789320 |
Authorized person
| Name | MRS. AMANDA P MULLIKIN |
| Role | ADMIN ASSISTANT |
| Phone | 7729787808 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 266151900 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD FL |
| Number | 45408 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WERNICKI PETER G | Director | 11840 SEAVIEW DRIVE, VERO BEACH, FL, 32963 |
| WILLIAMS ANDREW | Agent | 1575 INDIAN RIVER BLVD, VERO BEACH, FL, 32960 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000038465 | PRO SPORTS | ACTIVE | 2014-04-17 | 2029-12-31 | - | 787 37TH STREET, SUITE 200, VERO BEACH, FL, 32960 |
| G99257900093 | PRO SPORTS PROFESSIONAL SPORTS MEDICINE & ORTHOPAEDIC SURGERY | EXPIRED | 1999-09-14 | 2024-12-31 | - | 1355 37TH STREET, STE 301, VERO BEACH, FL, 32960 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2012-03-01 | WILLIAMS, ANDREW | - |
| REGISTERED AGENT ADDRESS CHANGED | 2006-09-12 | 1575 INDIAN RIVER BLVD, SUITE C-240, VERO BEACH, FL 32960 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2001-03-16 | 787 37TH Street,, SUITE E200, VERO BEACH, FL 32960 | - |
| CHANGE OF MAILING ADDRESS | 2001-03-16 | 787 37TH Street,, SUITE E200, VERO BEACH, FL 32960 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-02-06 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-03-26 |
| ANNUAL REPORT | 2020-03-09 |
| ANNUAL REPORT | 2019-03-15 |
| ANNUAL REPORT | 2018-02-22 |
| ANNUAL REPORT | 2017-03-15 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-02-21 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1720357204 | 2020-04-15 | 0455 | PPP | 1355 37th Stree, Vero Beach, FL, 32960 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
