| Entity Name: | LAKE MARY SURGERY CENTER, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
LAKE MARY SURGERY CENTER, L.L.C. 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: | 16 Sep 2002 (23 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 18 Nov 2008 (16 years ago) |
| Document Number: | L02000024087 |
| FEI/EIN Number |
134215228
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 340 Seven Springs Way, Suite 600, Brentwood, TN, 37027, US |
| Address: | 460 St. Charles Court, Lake Mary, FL, 32746, US |
| ZIP code: | 32746 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174530752 | 2006-08-03 | 2023-02-21 | 460 SAINT CHARLES CT, LAKE MARY, FL, 327462103, US | 460 SAINT CHARLES CT, LAKE MARY, FL, 327462103, US | |||||||||||||||||||||||||
|
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| Phone | +1 407-585-0260 |
| Fax | 4075850264 |
Authorized person
| Name | JENNIFER BOYD BALDOCK |
| Role | OFFICER AND AUTHORIZED OFFICIAL |
| Phone | 6152345954 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 1204 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 075897300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | - |
| BALDOCK JENNIFER | Manager | 340 Seven Springs Way, Suite 600, Brentwood, TN, 37027 |
| O'Brien Jeff | vp | 340 Seven Springs Way, Suite 600, Brentwood, TN, 37027 |
| Doherty Dave | vp | 340 Seven Springs Way, Suite 600, Brentwood, TN, 37027 |
| Kennedy Brett | vp | 340 Seven Springs Way, Suite 600, Brentwood, TN, 37027 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-08 | 460 St. Charles Court, Lake Mary, FL 32746 | - |
| CHANGE OF MAILING ADDRESS | 2024-04-19 | 460 St. Charles Court, Lake Mary, FL 32746 | - |
| REGISTERED AGENT NAME CHANGED | 2011-07-20 | CORPORATION SERVICE COMPANY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2011-07-20 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | - |
| LC AMENDMENT | 2008-11-18 | - | - |
| Name | Date |
|---|---|
| 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 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 02 May 2025
Sources: Florida Department of State
