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  5. CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC

CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC - Florida Company Profile

Company Details

Entity Name: CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company 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: 01 Feb 2001 (24 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 13 Sep 2016 (9 years ago)
Document Number: L01000001729
FEI/EIN Number 651071112

Federal Employer Identification (FEI) Number assigned by the IRS.
Mail Address: 14201 Dallas Parkway, Dallas, TX, 75254, US
Address: 23970 SUNCOAST BLVD., PORT CHARLOTTE, FL, 33980, US
ZIP code: 33980
County: Charlotte
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1730175159 2005-09-21 2024-09-18 23970 SUNCOAST BLVD, PORT CHARLOTTE, FL, 339802739, US 23970 SUNCOAST BLVD, PORT CHARLOTTE, FL, 339802739, US

Contacts
Phone +1 941-625-3636
Fax 9417647542

Authorized person
Name COLLIN LEMAISTRE
Role AUTHORIZED OFFICIAL
Phone 2142130732

Taxonomy
Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary Yes

Other Provider Identifiers
Issuer BC/BS FLORIDA
Number 69Z
State FL
Issuer MEDICAID
Number 075366100
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CHARLOTTE ENDOSCOPIC SURGERY CENTER 401(K) PLAN 2017 651071112 2018-10-11 CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621493
Sponsor’s telephone number 9416253636
Plan sponsor’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980

Plan administrator’s name and address
Administrator’s EIN 651071112
Plan administrator’s name CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC
Plan administrator’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980
Administrator’s telephone number 9416253636

Signature of
Role Plan administrator
Date 2018-10-11
Name of individual signing OLGA B. PETROSKY
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE ENDOSCOPIC SURGERY CENTER 401(K) PLAN 2016 651071112 2018-01-31 CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621493
Sponsor’s telephone number 9416253636
Plan sponsor’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980

Plan administrator’s name and address
Administrator’s EIN 651071112
Plan administrator’s name CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC
Plan administrator’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980
Administrator’s telephone number 9416253636

Signature of
Role Plan administrator
Date 2018-01-31
Name of individual signing OLGA B. PETROSKY
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE ENDOSCOPIC SURGERY CENTER 401(K) PLAN 2015 651071112 2016-10-12 CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621493
Sponsor’s telephone number 9416253636
Plan sponsor’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980

Plan administrator’s name and address
Administrator’s EIN 651071112
Plan administrator’s name CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC
Plan administrator’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980
Administrator’s telephone number 9416253636

Signature of
Role Plan administrator
Date 2016-10-12
Name of individual signing SALLY RUSSELL
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE ENDOSCOPIC SURGERY CENTER 401(K) PLAN 2014 651071112 2015-10-15 CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621493
Sponsor’s telephone number 9416253636
Plan sponsor’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980

Plan administrator’s name and address
Administrator’s EIN 651071112
Plan administrator’s name CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC
Plan administrator’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980
Administrator’s telephone number 9416253636

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing JERRY AKIN
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE ENDOSCOPIC SURGERY CENTER 401(K) PLAN 2013 651071112 2014-10-10 CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621493
Sponsor’s telephone number 9416253636
Plan sponsor’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980

Plan administrator’s name and address
Administrator’s EIN 651071112
Plan administrator’s name CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC
Plan administrator’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980
Administrator’s telephone number 9416253636

Signature of
Role Plan administrator
Date 2014-10-10
Name of individual signing SALLY RUSSELL
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE ENDOSCOPIC SURGERY CENTER 401(K) PLAN 2012 651071112 2013-08-22 CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621493
Sponsor’s telephone number 9416253636
Plan sponsor’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980

Plan administrator’s name and address
Administrator’s EIN 651071112
Plan administrator’s name CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC
Plan administrator’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980
Administrator’s telephone number 9416253636

Signature of
Role Plan administrator
Date 2013-08-22
Name of individual signing PATRICIA A. STANLEY
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE ENDOSCOPIC SURGERY CENTER 401(K) PLAN 2011 651071112 2012-05-09 CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621493
Sponsor’s telephone number 9416253636
Plan sponsor’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980

Plan administrator’s name and address
Administrator’s EIN 651071112
Plan administrator’s name CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC
Plan administrator’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980
Administrator’s telephone number 9416253636

Signature of
Role Plan administrator
Date 2012-05-08
Name of individual signing PAT STANLEY
Valid signature Filed with authorized/valid electronic signature
CHARLOTTE ENDOSCOPIC SURGERY CENTER 401(K) PLAN 2010 651071112 2011-06-15 CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621493
Sponsor’s telephone number 9416253636
Plan sponsor’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980

Plan administrator’s name and address
Administrator’s EIN 651071112
Plan administrator’s name CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC
Plan administrator’s address 23970 SUNCOAST BOULEVARD, PORT CHARLOTTE, FL, 33980
Administrator’s telephone number 9416253636

Signature of
Role Plan administrator
Date 2011-06-15
Name of individual signing PAT STANLEY
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
LeMaistre Collin President 14201 DALLAS PKWY, Dallas, TX, 75254
Bowden James Secretary 14201 Dallas Parkway, Dallas, TX, 75254
Sims Karen Auth 14201 DALLAS PKWY, Dallas, TX, 75254
C T CORPORATION SYSTEM Agent -

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G03114900111 CHARLOTTE SURGERY CENTER ACTIVE 2003-04-24 2028-12-31 - 23970 SUNCOAST BLVD, PORT CHARLOTTE, FL, 33980

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2020-05-27 23970 SUNCOAST BLVD., PORT CHARLOTTE, FL 33980 -
REGISTERED AGENT ADDRESS CHANGED 2016-09-13 1200 South Pine Island Road, Plantation, FL 33324 -
LC STMNT OF RA/RO CHG 2016-09-13 - -
REGISTERED AGENT NAME CHANGED 2016-09-13 C T CORPORATION SYSTEM -
REINSTATEMENT 2015-12-15 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2015-09-25 - -
CHANGE OF PRINCIPAL ADDRESS 2003-03-06 23970 SUNCOAST BLVD., PORT CHARLOTTE, FL 33980 -

Documents

Name Date
ANNUAL REPORT 2024-04-30
ANNUAL REPORT 2023-04-19
ANNUAL REPORT 2022-03-08
ANNUAL REPORT 2021-04-15
ANNUAL REPORT 2020-05-27
ANNUAL REPORT 2019-05-01
ANNUAL REPORT 2018-03-30
ANNUAL REPORT 2017-06-12
CORLCRACHG 2016-09-13
ANNUAL REPORT 2016-03-15

Companies related by officers

LeMaistre Collin

SURGCENTER NORTHEAST LLC - Active
Florida Limited Liability Co. (2012 )
SURGCENTER CLEARWATER, LLC - Active
Florida Limited Liability Co. (2017 )
SAFETY HARBOR ASC COMPANY, LLC - Active
Florida Limited Liability Co. (2017 )
SURGCENTER PINELLAS, LLC - Active
Florida Limited Liability Co. (2009 )
ORLANDO HEALTH/USP SURGERY CENTERS, L.L.C. - Active
Florida Limited Liability Co. (2013 )
LONGLEAF SURGERY CENTER, LLC - Active
Florida Limited Liability Co. (2013 )
TREASURE COAST ASC, LLC - Active
Florida Limited Liability Co. (2018 )
BARKLEY SURGICENTER, LLC - Active
Florida Limited Liability Co. (2021 )
SURGERY CENTRE OF SW FLORIDA, LLC - Active
Florida Limited Liability Co. (2011 )
ADVENTHEALTH SURGERY CENTER DAVENPORT, LLC - Active
Florida Limited Liability Co. (2022 )

Bowden James

SURGCENTER NORTHEAST LLC - Active
Florida Limited Liability Co. (2012 )
SURGCENTER CLEARWATER, LLC - Active
Florida Limited Liability Co. (2017 )
SAFETY HARBOR ASC COMPANY, LLC - Active
Florida Limited Liability Co. (2017 )
SURGCENTER PINELLAS, LLC - Active
Florida Limited Liability Co. (2009 )
SOUTH FLORIDA AMBULATORY SURGICAL CENTER, LLC - Active
Florida Limited Liability Co. (2000 )
THE SURGERY CENTER AT JENSEN BEACH, LLC - Active
Florida Limited Liability Co. (2003 )
ORLANDO HEALTH/USP SURGERY CENTERS, L.L.C. - Active
Florida Limited Liability Co. (2013 )
DESTIN ASC RE, LLC - Active
Florida Limited Liability Co. (2019 )
USP ORLANDO, INC. - Active
Domestic Profit (2013 )
LONGLEAF SURGERY CENTER, LLC - Active
Florida Limited Liability Co. (2013 )

Sims Karen

SURGCENTER NORTHEAST LLC - Active
Florida Limited Liability Co. (2012 )
SURGCENTER CLEARWATER, LLC - Active
Florida Limited Liability Co. (2017 )
SURGCENTER PINELLAS, LLC - Active
Florida Limited Liability Co. (2009 )
ORLANDO HEALTH/USP SURGERY CENTERS, L.L.C. - Active
Florida Limited Liability Co. (2013 )
DESTIN ASC RE, LLC - Active
Florida Limited Liability Co. (2019 )
USP ORLANDO, INC. - Active
Domestic Profit (2013 )
LONGLEAF SURGERY CENTER, LLC - Active
Florida Limited Liability Co. (2013 )
THE OUTPATIENT CENTER, LLC - Active
Florida Limited Liability Co. (2015 )
SURGICARE OF MIRAMAR, LLC - Active
Florida Limited Liability Co. (2007 )
TREASURE COAST ASC, LLC - Active
Florida Limited Liability Co. (2018 )

C T CORPORATION SYSTEM

BRENKA VIDEO US INC. - Inactive
Foreign Profit (1997 - 2000)
FFM HOLDING CORP. - Inactive
Foreign Profit (1997 - 2001)
GS SUNRISE, FL, LLC - Inactive
Foreign Limited Liability Co. (2004 - 2005)
HAMPTONS TOBACCO & NEWS, INC. - Inactive
Foreign Profit (1997 - 1998)
DHIR - ERIKSON PARKS, LLC - Active
Foreign Limited Liability Co. (2021 )
FLORIDA CENTRAL RAILROAD COMPANY, LLC - Active
Florida Limited Liability Co. (2021 )
TIMESHARE ADMINISTRATION GROUP, LLC - Active
Florida Limited Liability Co. (2017 )
MEMORIAL URGENT CARE - MANDARIN, LLC - Inactive
Florida Limited Liability Co. (2005 - 2010)
PILECAP, INCORPORATED - Inactive
Foreign Profit (1999 - 2004)
SOLARWINDS WORLDWIDE, LLC - Active
Foreign Limited Liability Co. (2023 )

Companies related by address

14201 Dallas Parkway, Dallas, TX, 75254, US

DESTIN SURGERY CENTER, LLC SURGERY CENTER OF PEMBROKE PINES, L.L.C. TITUSVILLE CENTER FOR SURGICAL EXCELLENCE, LLC MURDOCK AMBULATORY SURGERY CENTER, LLC SURGERY CENTRE OF SW FLORIDA, LLC SPECIALTY SURGICENTERS, INC. TITAN HEALTH OF TITUSVILLE, INC. NATIONAL SURGERY CENTER HOLDINGS, INC. SURGERY CENTER OF OKEECHOBEE, LLC ORLANDO HEALTH/USP SURGERY CENTERS, L.L.C.

Date of last update: 03 Mar 2025

Sources: Florida Department of State

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