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  5. SOUTH FLORIDA SURGICAL SPECIALISTS, LLC

SOUTH FLORIDA SURGICAL SPECIALISTS, LLC

Company Details

Entity Name: SOUTH FLORIDA SURGICAL SPECIALISTS, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 06 Oct 2004 (20 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 24 Sep 2015 (9 years ago)
Document Number: L04000072501
FEI/EIN Number 20-1759480
Address: 3001 CORAL HILLS DRIVE, SUITE 320, CORAL SPRINGS, FL 33065
Mail Address: 3001 CORAL HILLS DRIVE, SUITE 320, CORAL SPRINGS, FL 33065
ZIP code: 33065
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1346998812 2022-03-14 2022-03-14 3001 CORAL HILLS DR STE 320, CORAL SPRINGS, FL, 330654172, US 9980 CENTRAL PARK BLVD N STE 314, BOCA RATON, FL, 334281704, US

Contacts
Phone +1 954-755-0111
Fax 9547550243
Phone +1 561-483-3989
Fax 7532275792

Authorized person
Name MARK SHACHNER
Role OWNER
Phone 9547550111

Taxonomy
Taxonomy Code 208600000X - Surgery Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 401(K) SAFE HARBOR PROFIT SHARING PLAN 2017 201759480 2018-06-13 SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 119
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9547550111
Plan sponsor’s address 3001 CORAL HILLS DRIVE #320, CORAL SPRINGS, FL, 33065
SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 401(K) SAFE HARBOR PROFIT SHARING PLAN 2016 201759480 2017-11-06 SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 108
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9547550111
Plan sponsor’s address 3001 CORAL HILLS DRIVE #320, CORAL SPRINGS, FL, 33065
SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 401(K) SAFE HARBOR PROFIT SHARING PLAN 2015 201759480 2016-05-31 SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 83
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9547550111
Plan sponsor’s address 3001 CORAL HILLS DRIVE #320, CORAL SPRINGS, FL, 33065
SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 401(K) SAFE HARBOR PROFIT SHARING PLAN 2014 201759480 2015-09-23 SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 79
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9547550111
Plan sponsor’s address 3001 CORAL HILLS DRIVE #320, CORAL SPRINGS, FL, 33065
SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 401(K) SAFE HARBOR PROFIT SHARING PLAN 2013 201759480 2014-08-21 SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 70
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9547550111
Plan sponsor’s address 3001 CORAL HILLS DRIVE #320, CORAL SPRINGS, FL, 33065
SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 401(K) SAFE HARBOR PROFIT SHARING PLAN 2012 201759480 2013-09-05 SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 62
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9547550111
Plan sponsor’s address 3001 CORAL HILLS DRIVE #320, CORAL SPRINGS, FL, 33065

Signature of
Role Plan administrator
Date 2013-09-05
Name of individual signing MARK SHACHNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-05
Name of individual signing MARK SHACHNER
Valid signature Filed with authorized/valid electronic signature
SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 401(K) SAFE HARBOR PROFIT SHARING PLAN 2011 201759480 2012-10-04 SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 57
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9547550111
Plan sponsor’s address 3001 CORAL HILLS DRIVE #320, CORAL SPRINGS, FL, 33065

Plan administrator’s name and address
Administrator’s EIN 201759480
Plan administrator’s name SOUTH FLORIDA SURGICAL SPECIALISTS, LLC
Plan administrator’s address 3001 CORAL HILLS DRIVE #320, CORAL SPRINGS, FL, 33065
Administrator’s telephone number 9547550111

Signature of
Role Plan administrator
Date 2012-10-04
Name of individual signing MARK SHACHNER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-04
Name of individual signing MARK SHACHNER
Valid signature Filed with authorized/valid electronic signature
SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 401(K) SAFE HARBOR PROFIT SHARING PLAN 2010 201759480 2011-09-27 SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 36
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9547550111
Plan sponsor’s address 3001 CORAL HILLS DRIVE #320, CORAL SPRINGS, FL, 33065

Plan administrator’s name and address
Administrator’s EIN 201759480
Plan administrator’s name SOUTH FLORIDA SURGICAL SPECIALISTS, LLC
Plan administrator’s address 3001 CORAL HILLS DRIVE #320, CORAL SPRINGS, FL, 33065
Administrator’s telephone number 9547550111

Signature of
Role Plan administrator
Date 2011-09-27
Name of individual signing JUSTIN GULAREK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-27
Name of individual signing JUSTIN GULAREK
Valid signature Filed with authorized/valid electronic signature
SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 401(K) SAFE HARBOR PROFIT SHARING PLAN 2009 201759480 2010-10-07 SOUTH FLORIDA SURGICAL SPECIALISTS, LLC 35
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9547550111
Plan sponsor’s address 3001 CORAL HILLS DRIVE #320, CORAL SPRINGS, FL, 33065

Plan administrator’s name and address
Administrator’s EIN 201759480
Plan administrator’s name SOUTH FLORIDA SURGICAL SPECIALISTS, LLC
Plan administrator’s address 3001 CORAL HILLS DRIVE #320, CORAL SPRINGS, FL, 33065
Administrator’s telephone number 9547550111

Signature of
Role Plan administrator
Date 2010-10-07
Name of individual signing JUSTIN GULAREK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-07
Name of individual signing JUSTIN GULAREK
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Gularek, Justin C, MBA Agent 3001 CORAL HILLS DRIVE, SUITE 320, CORAL SPRINGS, FL 33065

Manager

Name Role Address
SHACHNER, MARK Manager 3001 CORAL HILLS DRIVE SUITE 320, CORAL SPRINGS, FL 33065

Vice President

Name Role Address
KIMMELMAN, RANDY Vice President 3467 W. HILLSBORO BLVD, SUITE B, DEERFIELD BEACH, FL 33442

Secretary

Name Role Address
STRICOFF, RONALD Secretary 3467 W. HILLSBORO BLVD, SUITE B, DEERFIELD BEACH, FL 33442

Treasurer

Name Role Address
PORUDOMINSKY, DAVID Treasurer 2825 NORTH STATE RD., MARGATE, FL 33063

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000060704 SOUTH FLORIDA SPECIALISTS EXPIRED 2016-06-20 2021-12-31 No data 3001 CORAL HILLS DR, STE 320, CORAL SPRINGS, FL, 33065

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2016-02-01 Gularek, Justin C, MBA No data
LC STMNT OF RA/RO CHG 2015-09-24 No data No data
REGISTERED AGENT ADDRESS CHANGED 2012-08-23 3001 CORAL HILLS DRIVE, SUITE 320, CORAL SPRINGS, FL 33065 No data
CHANGE OF PRINCIPAL ADDRESS 2009-03-16 3001 CORAL HILLS DRIVE, SUITE 320, CORAL SPRINGS, FL 33065 No data
CHANGE OF MAILING ADDRESS 2009-03-16 3001 CORAL HILLS DRIVE, SUITE 320, CORAL SPRINGS, FL 33065 No data

Documents

Name Date
ANNUAL REPORT 2024-02-01
ANNUAL REPORT 2023-02-03
ANNUAL REPORT 2022-01-24
ANNUAL REPORT 2021-01-11
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-02-11
ANNUAL REPORT 2018-01-29
ANNUAL REPORT 2017-01-27
ANNUAL REPORT 2016-02-01
CORLCRACHG 2015-09-24

Related by officers

SHACHNER, MARK

SFSS SURGERY CENTER INVESTORS, LLC SOUTH FLORIDA REFLUX CENTER, LLC

STRICOFF, RONALD

RONALD STRICOFF, M.D., PLLC

PORUDOMINSKY, DAVID

POKAS, LLC LA TINA, LLC

Related by address

3001 CORAL HILLS DRIVE, SUITE 320, CORAL SPRINGS, FL 33065

CORAL REALTY INVESTMENT, LLC

3001 CORAL HILLS DRIVE, SUITE 320, CORAL SPRINGS, FL 33065

CORAL REALTY INVESTMENT, LLC

Date of last update: 05 Jan 2025

Sources: Florida Department of State

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