| Entity Name: | SOUTH BROWARD SURGICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 09 Jun 2004 (21 years ago) |
| Date of dissolution: | 01 Oct 2014 (10 years ago) |
| Last Event: | VOLUNTARY DISS W/ NOTICE |
| Event Date Filed: | 01 Oct 2014 (10 years ago) |
| Document Number: | L04000043542 |
| FEI/EIN Number | 201224718 |
| Address: | 601 N. FLAMINGO RD., SUITE 211, PEMBROKE PINES, FL, 33028 |
| Mail Address: | 601 N. FLAMINGO RD., SUITE 211, PEMBROKE PINES, FL, 33028 |
| ZIP code: | 33028 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619015658 | 2007-02-02 | 2008-10-15 | PO BOX 260939, PEMBROKE PINES, FL, 330267939, US | 601 N FLAMINGO RD, SUITE 211, PEMBROKE PINES, FL, 330281015, US | |||||||||||||||||||||
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| Phone | +1 954-447-4480 |
| Fax | 9544475344 |
Authorized person
| Name | DR. DEXTER C SEREDA |
| Role | MANAGING PARTNER |
| Phone | 9544474480 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 270575300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LICKO CAROL | Agent | HOGAN AND HARTSON, LLP, 1111 BRICKEL AVE., MIAMI, FL, 33131 |
| Name | Role | Address |
|---|---|---|
| SEREDA DEXTER | Managing Member | 8919 NW 34TH STREET, COOPER CITY, FL, 33024 |
| PIDHORECKY IHOR | Managing Member | 411 N NEW RIVER DRIVE EAST #3004, FT. LAUDERDALE, FL, 33301 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC VOLUNTARY DISSOLUTION | 2014-10-01 | No data | WITH NOTICE |
| VOLUNTARY DISS W/ NOTICE | 2014-10-01 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-01-05 | 601 N. FLAMINGO RD., SUITE 211, PEMBROKE PINES, FL 33028 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-01-10 | 601 N. FLAMINGO RD., SUITE 211, PEMBROKE PINES, FL 33028 | No data |
| AMENDMENT | 2004-11-23 | No data | No data |
| Name | Date |
|---|---|
| Reg. Agent Resignation | 2014-10-30 |
| LC Voluntary Dissolution | 2014-10-01 |
| ANNUAL REPORT | 2014-06-17 |
| ANNUAL REPORT | 2013-04-16 |
| ANNUAL REPORT | 2012-06-06 |
| ANNUAL REPORT | 2012-02-22 |
| ANNUAL REPORT | 2011-03-25 |
| ANNUAL REPORT | 2010-01-05 |
| ANNUAL REPORT | 2009-02-25 |
| ANNUAL REPORT | 2008-01-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
