| Entity Name: | MERRITT ISLAND ASC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 18 Nov 2004 (20 years ago) |
| Date of dissolution: | 02 Jan 2019 (6 years ago) |
| Last Event: | LC STMNT OF TERM |
| Event Date Filed: | 02 Jan 2019 (6 years ago) |
| Document Number: | L04000084083 |
| FEI/EIN Number | 201915971 |
| Address: | 4000 MERIDIAN BOULEVARD, FRANKLIN, TN, 37067, US |
| Mail Address: | 4000 MERIDIAN BOULEVARD, FRANKLIN, TN, 37067, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912952144 | 2006-05-24 | 2007-10-10 | 2400 N COURTENAY PKWY, SUITE 2, MERRITT ISLAND, FL, 329534127, US | 2400 N COURTENAY PKWY, SUITE 2, MERRITT ISLAND, FL, 329534127, US | |||||||||||||||||||||||||
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| Phone | +1 321-454-4007 |
| Fax | 3215760257 |
Authorized person
| Name | MS. DONNA M. SCROGGINS |
| Role | MANAGER |
| Phone | 5616303277 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 1249 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE ASC LICENSE |
| Number | 1249 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role |
|---|---|
| BREVARD HMA ASC, LLC | Manager |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF TERM | 2019-01-02 | No data | No data |
| VOLUNTARY DISSOLUTION | 2018-12-31 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2017-01-19 | 4000 MERIDIAN BOULEVARD, FRANKLIN, TN 37067 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-01-19 | 4000 MERIDIAN BOULEVARD, FRANKLIN, TN 37067 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-01-18 | 1201 Hays Street, Tallahassee, FL 32301 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-01-18 | CORPORATION SERVICE COMPANY | No data |
| REINSTATEMENT | 2008-07-31 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| REINSTATEMENT | 2005-11-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| Name | Date |
|---|---|
| CORLCSTERM | 2019-01-02 |
| VOLUNTARY DISSOLUTION | 2018-12-31 |
| ANNUAL REPORT | 2018-04-25 |
| AMENDED ANNUAL REPORT | 2017-01-19 |
| ANNUAL REPORT | 2017-01-18 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-09 |
| ANNUAL REPORT | 2014-01-08 |
| ANNUAL REPORT | 2013-01-22 |
| ANNUAL REPORT | 2012-01-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
