| Entity Name: | WEST PARK SURGERY CENTER, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 07 Jul 2004 (21 years ago) |
| Document Number: | L04000050625 |
| FEI/EIN Number | 26-0092101 |
| Address: | 501 N. Reo Street, Tampa, FL 33609 |
| Mail Address: | 501 N. Reo Street, Tampa, FL 33609 |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043272750 | 2006-04-06 | 2023-06-26 | PO BOX 628781, ORLANDO, FL, 328628781, US | 6640 78TH AVE, SUITE B, PINELLAS PARK, FL, 337812053, US | |||||||||||||||||||||||||||
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| Phone | +1 727-549-0610 |
| Fax | 7275490620 |
| Fax | 7275188662 |
Authorized person
| Name | JOSHUA HELMS |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 8135492134 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 282N00000X - General Acute Care Hospital |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 101021100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Wood, David | Agent | 504 N. REO STREET, TAMPA, FL 33609 |
| Name | Role | Address |
|---|---|---|
| Helms, Josh | Chief Executive Officer | 504 N. REO STREET, TAMPA, FL 33609 |
| Name | Role | Address |
|---|---|---|
| Gari, Tracie | Chief Administrative Officer | 504 N. REO STREET, TAMPA, FL 33609 |
| Name | Role | Address |
|---|---|---|
| WOOD, DAVID A | President | 501 N. REO STREET, TAMPA, FL 33609 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-05-23 | 501 N. Reo Street, Tampa, FL 33609 | No data |
| CHANGE OF MAILING ADDRESS | 2023-05-23 | 501 N. Reo Street, Tampa, FL 33609 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-03-14 | Wood, David | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-26 | 504 N. REO STREET, TAMPA, FL 33609 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-03-14 |
| ANNUAL REPORT | 2022-03-30 |
| ANNUAL REPORT | 2021-03-12 |
| ANNUAL REPORT | 2020-06-26 |
| ANNUAL REPORT | 2019-04-20 |
| AMENDED ANNUAL REPORT | 2018-09-07 |
| ANNUAL REPORT | 2018-02-16 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-03-02 |
Date of last update: 05 Jan 2025
Sources: Florida Department of State
