| Entity Name: | GATEWAY SURGICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 30 Jun 2004 (21 years ago) |
| Date of dissolution: | 30 Dec 2010 (14 years ago) |
| Last Event: | LC VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 Dec 2010 (14 years ago) |
| Document Number: | L04000049265 |
| FEI/EIN Number | 201327129 |
| Address: | ONE PARK PLAZA, NASHVILLE, TN, 37203, US |
| Mail Address: | PO BOX 750, NASHVILLE, TN, 37202, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104868413 | 2006-06-12 | 2008-01-14 | 3140 NW MEDICAL CENTER LN, SUITE 120, LAKE CITY, FL, 320554717, US | 3140 NW MEDICAL CENTER LN, SUITE 120, LAKE CITY, FL, 320554717, US | |||||||||||||||||||||
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| Phone | +1 386-755-6682 |
| Fax | 3867556796 |
Authorized person
| Name | MICKEY PICKLER |
| Role | VP |
| Phone | 3867556682 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS OF FL |
| Number | 94830 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| RUTHERFORD WILLIAM B | Manager | ONE PARK PLAZA, NASHVILLE, TN, 37203 |
| MOORE A. BRUCE J | Manager | ONE PARK PLAZA, NASHVILLE, TN, 37203 |
| JOHNSON R. MILTON | Manager | ONE PARK PLAZA, NASHVILLE, TN, 37203 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC VOLUNTARY DISSOLUTION | 2010-12-30 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2008-04-17 | ONE PARK PLAZA, NASHVILLE, TN 37203 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-04-28 | ONE PARK PLAZA, NASHVILLE, TN 37203 | No data |
| Name | Date |
|---|---|
| LC Voluntary Dissolution | 2010-12-30 |
| ANNUAL REPORT | 2010-04-23 |
| ANNUAL REPORT | 2009-03-30 |
| ANNUAL REPORT | 2008-04-17 |
| ANNUAL REPORT | 2007-05-01 |
| ANNUAL REPORT | 2006-04-21 |
| ANNUAL REPORT | 2005-04-28 |
| Florida Limited Liabilites | 2004-06-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
