| Entity Name: | SURGICAL SPECIALISTS OF SOUTHWEST FLORIDA, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
SURGICAL SPECIALISTS OF SOUTHWEST FLORIDA, 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: | 13 Sep 1968 (57 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 08 Oct 2004 (21 years ago) |
| Document Number: | 600448 |
| FEI/EIN Number |
591218806
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 6821 PALISADES PARK COURT, FT. MYERS, FL, 33912, US |
| Mail Address: | 6821 PALISADES PARK COURT, FT. MYERS, FL, 33912, US |
| ZIP code: | 33912 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033103437 | 2005-08-31 | 2014-07-03 | 6821 PALISADES PARK CT, SUITE 1, FORT MYERS, FL, 339127131, US | 6821 PALISADES PARK CT, SUITE 1, FORT MYERS, FL, 339127131, US | |||||||||||||||||||||||||
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| Phone | +1 239-936-8555 |
| Fax | 2399365611 |
Authorized person
| Name | DR. GORDON D BURTCH |
| Role | PRESIDENT |
| Phone | 2399368555 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 2086S0129X - Vascular Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 052343700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KALRA AJAY MD | President | 6821 PALISADES PARK COURT, FT. MYERS, FL, 33912 |
| Manibo Jose' FMD | Vice President | 6821 Palisades Park Court, Fort Myers, FL, 33912 |
| Moss John AMD | Secretary | 6821 Palisades Park Court, Fort Myers, FL, 33912 |
| Kammerlocher Thad CMD | Treasurer | 6821 Palisades Park Court, Fort Myers, FL, 33912 |
| D'Angelo Anthony JDr. | Member | 6821 Palisades Park Court, Fort Myers, FL, 33912 |
| KALRA AJAY M | Agent | 6821 PALISADES PARK COURT, FT. MYERS, FL, 33912 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-09 | 6821 PALISADES PARK COURT, SUITE 1, FT. MYERS, FL 33912 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2018-03-09 | 6821 PALISADES PARK COURT, SUITE 1, FT. MYERS, FL 33912 | - |
| CHANGE OF MAILING ADDRESS | 2018-03-09 | 6821 PALISADES PARK COURT, SUITE 1, FT. MYERS, FL 33912 | - |
| REGISTERED AGENT NAME CHANGED | 2009-04-06 | KALRA, AJAY MD | - |
| CANCEL ADM DISS/REV | 2004-10-08 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | - | - |
| NAME CHANGE AMENDMENT | 1996-09-23 | SURGICAL SPECIALISTS OF SOUTHWEST FLORIDA, P.A. | - |
| AMENDMENT | 1994-04-06 | - | - |
| NAME CHANGE AMENDMENT | 1990-02-27 | HAGEN, BACON AND SWEENEY SURGICAL GROUP, P.A. | - |
| NAME CHANGE AMENDMENT | 1982-07-16 | HAGEN AND BACON SURGICAL GROUP, P.A. | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-19 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-01-13 |
| ANNUAL REPORT | 2016-01-21 |
| ANNUAL REPORT | 2015-02-23 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
