| Entity Name: | TAKE SHAPE SURGERY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Dec 2004 (20 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 18 Oct 2021 (3 years ago) |
| Document Number: | L04000089599 |
| FEI/EIN Number | 342026859 |
| Address: | 4161 NW 5TH STREET, SUITE 100, PLANTATION, FL, 33317, US |
| Mail Address: | 4161 NW 5TH STREET, SUITE 100, PLANTATION, FL, 33317, US |
| ZIP code: | 33317 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497704985 | 2006-05-10 | 2020-08-22 | 4161 NW 5TH ST, SUITE 100, PLANTATION, FL, 33317, US | 4161 NW 5TH ST, SUITE 100, PLANTATION, FL, 33317, US | |||||||||||||||||||
|
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| Phone | +1 954-585-3800 |
| Fax | 9545856100 |
Authorized person
| Name | DR. RUSSELL FRANK SASSANI |
| Role | PRESIDENT CEO |
| Phone | 9545853800 |
Taxonomy
| Taxonomy Code | 208200000X - Plastic Surgery Physician |
| License Number | FL1224 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SASSANI RUSSELL FM.D. | Agent | 4161 NW 5TH STREET, PLANTATION, FL, 33317 |
| Name | Role | Address |
|---|---|---|
| SASSANI RUSSELL FM.D. | Managing Member | 4161 NW 5TH STREET, SUITE 100, PLANTATION, FL, 33317 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2021-10-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-06 | SASSANI, RUSSELL F., M.D. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-26 |
| ANNUAL REPORT | 2023-03-06 |
| AMENDED ANNUAL REPORT | 2022-08-22 |
| ANNUAL REPORT | 2022-01-24 |
| REINSTATEMENT | 2021-10-18 |
| ANNUAL REPORT | 2020-05-28 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-03-20 |
| ANNUAL REPORT | 2017-03-16 |
| ANNUAL REPORT | 2016-03-10 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
