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  5. PANAMA CITY SURGERY CENTER, LLC

PANAMA CITY SURGERY CENTER, LLC

Company Details

Entity Name: PANAMA CITY SURGERY CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 03 Apr 2002 (23 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 25 Jul 2023 (2 years ago)
Document Number: L02000008069
FEI/EIN Number 481255983
Address: 1800 JENKS AVENUE, PANAMA CITY, FL, 32405, US
Mail Address: 1800 JENKS AVENUE, PANAMA CITY, FL, 32405, US
ZIP code: 32405
County: Bay
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1023088473 2006-01-26 2022-07-29 1800 JENKS AVE, PANAMA CITY, FL, 324054642, US 1800 JENKS AVE, PANAMA CITY, FL, 324054642, US

Contacts
Phone +1 850-769-3191
Fax 8507693192

Authorized person
Name MR. MICHAEL MADEWELL
Role ADMINISTRATOR
Phone 8507693191

Taxonomy
Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
License Number 1178
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 075701200
State FL

Central Index Key

CIK number Mailing Address Business Address Phone
1175074 1800 JENKS AVENUE, PANAMA CITY, FL, 32405 1800 JENKS AVENUE, PANAMA CITY, FL, 32405 850-769-3191

Filings since 2024-05-02
Form type D
File number 021-512151
Filing date 2024-05-02
File View File

Filings since 2023-06-09
Form type D
File number 021-483893
Filing date 2023-06-09
File View File

Filings since 2022-01-14
Form type D
File number 021-429529
Filing date 2022-01-14
File View File

Filings since 2020-12-28
Form type D
File number 021-384385
Filing date 2020-12-28
File View File

Filings since 2002-05-28
Form type REGDEX
File number 021-44227
Filing date 2002-05-28
File View File

Filings since 2002-05-21
Form type REGDEX
File number 021-44227
Filing date 2002-05-21
File View File

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2020 481255983 2021-09-29 PANAMA CITY SURGERY CENTER, LLC 101
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-11-17
Business code 812990
Sponsor’s telephone number 8507693191
Plan sponsor’s address 1800 JENKS AVENUE, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2021-09-29
Name of individual signing MICHAEL MADEWELL
Valid signature Filed with authorized/valid electronic signature
PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2019 481255983 2021-01-14 PANAMA CITY SURGERY CENTER, LLC 99
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-11-17
Business code 812990
Sponsor’s telephone number 8507693191
Plan sponsor’s address 1800 JENKS AVENUE, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2021-01-14
Name of individual signing MICHAEL MADEWELL
Valid signature Filed with authorized/valid electronic signature
PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2018 481255983 2019-10-08 PANAMA CITY SURGERY CENTER, LLC 97
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-11-17
Business code 812990
Sponsor’s telephone number 8507693191
Plan sponsor’s address 1800 JENKS AVENUE, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2019-10-08
Name of individual signing MICHAEL MADEWELL
Valid signature Filed with authorized/valid electronic signature
PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2017 481255983 2019-02-28 PANAMA CITY SURGERY CENTER, LLC 85
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-11-17
Business code 812990
Sponsor’s telephone number 8507693191
Plan sponsor’s address 1800 JENKS AVENUE, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2019-02-28
Name of individual signing MICHAEL MADEWELL
Valid signature Filed with authorized/valid electronic signature
PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2016 481255983 2017-10-13 PANAMA CITY SURGERY CENTER, LLC 69
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-11-17
Business code 812990
Plan sponsor’s address 1800 JENKS AVENUE, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2017-10-13
Name of individual signing MICHAEL MADEWELL
Valid signature Filed with authorized/valid electronic signature
PANAMA CITY SURGERY CENTER, LLC 401K PLAN 2014 481255983 2015-06-30 PANAMA CITY SURGERY CENTER, LLC 86
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-10-01
Business code 621493
Sponsor’s telephone number 8507693191
Plan sponsor’s address 1800 JENKS AVENUE, PANAMA CITY, FL, 32405
PANAMA CITY SURGERY CENTER, LLC 401K PLAN 2013 481255983 2014-10-06 PANAMA CITY SURGERY CENTER, LLC 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-10-01
Business code 621493
Sponsor’s telephone number 8507693191
Plan sponsor’s address 1800 JENKS AVENUE, PANAMA CITY, FL, 32405
PANAMA CITY SURGERY CENTER, LLC 401K PLAN 2012 481255983 2013-10-09 PANAMA CITY SURGERY CENTER, LLC 61
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-10-01
Business code 621493
Sponsor’s telephone number 8507693191
Plan sponsor’s address 1800 JENKS AVENUE, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2013-10-09
Name of individual signing MIKE MADEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-09
Name of individual signing MIKE MADEWELL
Valid signature Filed with authorized/valid electronic signature
PANAMA CITY SURGERY CENTER, LLC 401K PLAN 2011 481255983 2012-09-06 PANAMA CITY SURGERY CENTER, LLC 55
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-10-01
Business code 621493
Sponsor’s telephone number 8507693191
Plan sponsor’s address 1800 JENKS AVENUE, PANAMA CITY, FL, 32405

Plan administrator’s name and address
Administrator’s EIN 481255983
Plan administrator’s name PANAMA CITY SURGERY CENTER, LLC
Plan administrator’s address 1800 JENKS AVENUE, PANAMA CITY, FL, 32405
Administrator’s telephone number 8507693191

Signature of
Role Plan administrator
Date 2012-09-06
Name of individual signing MIKE MADEWELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-06
Name of individual signing MIKE MADEWELL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
C T CORPORATION SYSTEM Agent

Managing Member

Name Role Address
HITT WARREN Managing Member 1800 JENKS AVE, PANAMA CITY, FL, 32405
Madewell Michael Managing Member 408 E Beach Drive, PANAMA CITY, FL, 32401
SPENCER ROGER M Managing Member 1800 JENKS AVE, PANAMA CITY, FL, 32405

Events

Event Type Filed Date Value Description
LC STMNT OF RA/RO CHG 2023-07-25 No data No data
REGISTERED AGENT NAME CHANGED 2023-07-25 C T CORPORATION SYSTEM No data
REGISTERED AGENT ADDRESS CHANGED 2023-07-25 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 No data
LC STMNT OF RA/RO CHG 2020-02-11 No data No data
CHANGE OF PRINCIPAL ADDRESS 2009-04-15 1800 JENKS AVENUE, PANAMA CITY, FL 32405 No data
CHANGE OF MAILING ADDRESS 2009-04-15 1800 JENKS AVENUE, PANAMA CITY, FL 32405 No data

Documents

Name Date
ANNUAL REPORT 2024-03-13
CORLCRACHG 2023-07-25
ANNUAL REPORT 2023-02-13
ANNUAL REPORT 2022-01-29
ANNUAL REPORT 2021-02-02
ANNUAL REPORT 2020-02-17
CORLCRACHG 2020-02-11
ANNUAL REPORT 2019-04-29
ANNUAL REPORT 2018-03-05
ANNUAL REPORT 2017-03-15

Related by officers

HITT WARREN

HITT FAMILY HOLDINGS, L.L.C.

Madewell Michael

CLAIMPRO II, LLC WHITE SANDS MEDICAL LLC GLACIER ICE, LLC MILLENNIUM DME SALES, LLC EMERALD COAST IPA, INC. EMERALD WATERS MGMA INC DEEP HARBOUR,LLC GRAND BAY ASSOCIATION, INC.

SPENCER ROGER M

PANAMA CITY SURGICAL PROPERTIES, LLC

Related by address

1800 JENKS AVENUE, PANAMA CITY, FL, 32405, US

BAY SUPPORT SERVICES LLC PANAMA CITY SURGICAL PROPERTIES I, LLC PANAMA CITY SURGICAL PROPERTIES II, LLC PANAMA CITY SURGICAL PROPERTIES, LLC

1800 JENKS AVENUE, PANAMA CITY, FL, 32405, US

BAY SUPPORT SERVICES LLC PANAMA CITY SURGICAL PROPERTIES I, LLC PANAMA CITY SURGICAL PROPERTIES II, LLC PANAMA CITY SURGICAL PROPERTIES, LLC

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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