| Entity Name: | TWIN LAKES SURGERY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 21 Feb 2003 (22 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | L03000006467 |
| FEI/EIN Number | 542097061 |
| Address: | 1890 LPGA BOULEVARD, SUITE 200, DAYTONA BEACH, FL, 32117 |
| Mail Address: | 1890 LPGA BOULEVARD, SUITE 200, DAYTONA BEACH, FL, 32117 |
| ZIP code: | 32117 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679591515 | 2006-07-18 | 2020-08-22 | 1890 LPGA BLVD, SUITE 200, DAYTONA BEACH, FL, 321177130, US | 1890 LPGA BLVD, SUITE 200, DAYTONA BEACH, FL, 321177130, US | |||||||||||||||||||
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| Phone | +1 386-274-3232 |
| Fax | 3862741838 |
Authorized person
| Name | DEBBIE BOYER |
| Role | CODER |
| Phone | 3862743232 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 1207 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BIANCHI JOSEPH DDr. | Agent | 1890 LPGA BLVD STE 200, DAYTONA BEACH, FL, 32117 |
| Name | Role | Address |
|---|---|---|
| CARBIENER PAMELA B | Managing Member | 30 TWELVE OAKS TRAIL, ORMOND BEACH, FL, 32174 |
| GILLESPY ALBERT M | Managing Member | 1890 LPGA BLVD. STE. 200, DAYTONA BEACH, FL, 32117 |
| BIANCHI JOSEPH DDr. | Managing Member | 1890 LPGA Blvd, DAYTONA BEACH, FL, 32114 |
| LAPHAM DIANE M | Managing Member | 1890 LPGA BLVD STE 200, DAYTONA BEACH, FL, 32117 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REINSTATEMENT | 2020-03-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-10 | 1890 LPGA BLVD STE 200, DAYTONA BEACH, FL 32117 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-10 | BIANCHI, JOSEPH D, Dr. | No data |
| CHANGE OF MAILING ADDRESS | 2005-01-19 | 1890 LPGA BOULEVARD, SUITE 200, DAYTONA BEACH, FL 32117 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-04-12 | 1890 LPGA BOULEVARD, SUITE 200, DAYTONA BEACH, FL 32117 | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2020-03-10 |
| ANNUAL REPORT | 2018-04-13 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-13 |
| ANNUAL REPORT | 2014-04-08 |
| ANNUAL REPORT | 2013-04-10 |
| ANNUAL REPORT | 2012-04-30 |
| ANNUAL REPORT | 2011-04-29 |
| ANNUAL REPORT | 2010-04-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
