| Entity Name: | COLUMBIA EYE AND SPECIALTY SURGERY CENTER, LTD. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Limited Partnership |
| Status: | Active |
| Date Filed: | 03 Oct 1996 (28 years ago) |
| Document Number: | A96000001841 |
| FEI/EIN Number | 752528760 |
| Address: | ONE PARK PLAZA, NASHVILLE, TN, 37203, US |
| Mail Address: | P.O. BOX 750, LEGAL DEPT., NASHVILLE, TN, 37202, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376507194 | 2006-04-17 | 2018-02-06 | 4302 N GOMEZ AVE, TAMPA, FL, 336076312, US | 4302 N GOMEZ AVE, TAMPA, FL, 336076312, US | |||||||||||||||||||||||||
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| Phone | +1 813-870-6330 |
| Fax | 8138713956 |
Authorized person
| Name | WILLIAM G SWINNEY |
| Role | VP |
| Phone | 9727892877 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 870 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 062949900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G99035900007 | TAMPA EYE & SPECIALTY SURGERY CENTER | EXPIRED | 1999-02-04 | 2024-12-31 | No data | ONE PARK PLAZA, LEGAL DEPT., NASHVILLE, TN, 37203 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 1997-02-19 | COLUMBIA EYE AND SPECIALTY SURGERY CENTER, LTD. | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
