| Entity Name: | LARGO SURGERY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
LARGO SURGERY, 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. |
| 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 Dec 2001 (23 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 27 Jan 2016 (9 years ago) |
| Document Number: | L01000021601 |
| FEI/EIN Number |
010553657
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1401 W Bay Dr, Largo, FL, 33770, US |
| Mail Address: | 1401 W. Bay Drive, Largo, FL, 33770, US |
| ZIP code: | 33770 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831195379 | 2005-06-21 | 2023-06-26 | 1401 W BAY DR, LARGO, FL, 337702207, US | 1401 W BAY DR, LARGO, FL, 337702207, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-585-9500 |
| Fax | 7275841938 |
Authorized person
| Name | JENNIFER BOYD BALDOCK |
| Role | OFFICER AND AUTHORIZED |
| Phone | 6152345954 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 781 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 800005342 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 070644200 |
| State | FL |
| Issuer | CIGNA |
| Number | 0771519008 |
| Issuer | BLUE CROSS/BLUE SHIELD |
| Number | 691 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| National Kidney Partners L.L.P. | Agent | 14134 Nephron Lane, Hudson, FL, 34667 |
| Sharma Tushar Dr. | Manager | 14134 Nephron Lane, Hudson, FL, 34667 |
| Bidani Jatin Dr. | Manager | 1401 W. Bay Drive, Largo, FL, 33770 |
| Brucculeri Michael Dr. | Manager | 14134 Nephron Lane, Hudson, FL, 34667 |
| Paxton Lani LDr. | Auth | 14134 Nephron Lane, Hudson, FL, 34667 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08240900256 | WEST BAY SURGERY CENTER | ACTIVE | 2008-08-27 | 2028-12-31 | - | 310 SEVEN SPRINGS WAY, STE 500, BRENTWOOD, TN, 37027 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2025-01-06 | 14134 Nephron Lane, Hudson, FL 34667 | - |
| REGISTERED AGENT NAME CHANGED | 2025-01-06 | National Kidney Partners L.L.P. | - |
| CHANGE OF MAILING ADDRESS | 2025-01-06 | 1401 W Bay Dr, Largo, FL 33770 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2024-12-09 | 1401 W Bay Dr, Largo, FL 33770 | - |
| LC STMNT OF RA/RO CHG | 2016-01-27 | - | - |
| REINSTATEMENT | 2008-06-18 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | - | - |
| REINSTATEMENT | 2005-03-09 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | - | - |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2025-01-14 |
| ANNUAL REPORT | 2025-01-06 |
| ANNUAL REPORT | 2024-04-19 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-04-22 |
| ANNUAL REPORT | 2021-04-22 |
| ANNUAL REPORT | 2020-02-05 |
| ANNUAL REPORT | 2019-03-01 |
| ANNUAL REPORT | 2018-01-25 |
| ANNUAL REPORT | 2017-04-24 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
