| Entity Name: | TAMPA BAY SPECIALTY SURGERY CENTER, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 26 Aug 2002 (22 years ago) |
| Date of dissolution: | 14 Jan 2020 (5 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 14 Jan 2020 (5 years ago) |
| Document Number: | L02000021899 |
| FEI/EIN Number | 331019420 |
| Mail Address: | 6500 66TH STREET NORTH, PINELLAS PARK, FL, 33781, US |
| Address: | 6500 - 66TH ST N., PINELLAS PARK, FL, 33781 |
| ZIP code: | 33781 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992700090 | 2005-06-15 | 2023-09-07 | 6500 66TH STREET NORTH, PINELLAS PARK, FL, 33781, US | 6500 66TH STREET NORTH, PINELLAS PARK, FL, 33781, US | |||||||||||||||||||||||||
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| Phone | +1 727-828-1460 |
| Fax | 7278281469 |
Authorized person
| Name | MR. PHILLIP A. CLENDENIN |
| Role | PRESIDENT |
| Phone | 6156651283 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 1174 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | P00095116 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Sharf Howard W | Agent | 6500 66TH STREET NORTH, PINELLAS PARK, FL, 33781 |
| Name | Role |
|---|---|
| SOUTH EAST MEDICAL INVESTMENTS, LLC | Managing Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2020-01-14 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-03-17 | 6500 66TH STREET NORTH, PINELLAS PARK, FL 33781 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-03-17 | Sharf, Howard W | No data |
| CHANGE OF MAILING ADDRESS | 2016-07-14 | 6500 - 66TH ST N., PINELLAS PARK, FL 33781 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-13 | 6500 - 66TH ST N., PINELLAS PARK, FL 33781 | No data |
| AMENDMENT | 2003-07-29 | No data | No data |
| NAME CHANGE AMENDMENT | 2003-01-14 | TAMPA BAY SPECIALTY SURGERY CENTER, L.L.C. | No data |
| NAME CHANGE AMENDMENT | 2002-08-30 | TAMPA BAY SPECIALTY SURGICAL CENTER, L.L.C. | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2020-01-14 |
| ANNUAL REPORT | 2019-04-07 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-03-17 |
| AMENDED ANNUAL REPORT | 2016-07-14 |
| ANNUAL REPORT | 2016-03-30 |
| ANNUAL REPORT | 2015-03-31 |
| ANNUAL REPORT | 2014-03-25 |
| ANNUAL REPORT | 2013-04-16 |
| ANNUAL REPORT | 2012-04-13 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
