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ORANGE CITY SURGERY CENTER, LLC

Company Details

Entity Name: ORANGE CITY SURGERY CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 03 Nov 2005 (19 years ago)
Document Number: L05000107158
FEI/EIN Number 593831266
Mail Address: 340 SEVEN SPRINGS WAY, BRENTWOOD, TN, 37027, US
Address: Suite 600 340 Seven Springs Way, Brentwood, TN, 37027, US
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1487840740 2007-09-20 2020-02-21 963 TOWN CENTER DR, SUITE 100, ORANGE CITY, FL, 327638254, US 975 TOWN CENTER DR, SUITE 100, ORANGE CITY, FL, 327638361, US

Contacts
Phone +1 866-631-7890

Authorized person
Name JENNIFER BOYD BALDOCK
Role OFFICER AND AUTHORIZED OFFICIAL
Phone 6152345900

Taxonomy
Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ORANGE CITY SURGERY CENTER EMPLOYEE RETIREMENT PLAN 2012 593831266 2013-09-27 ORANGE CITY SURGERY CENTER, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3864565247
Plan sponsor’s address 975 TOWN CENTER DRIVE, SUITE 100, ORANGE CITY, FL, 32763

Signature of
Role Plan administrator
Date 2013-09-27
Name of individual signing KEVIN BARBER, MD
Valid signature Filed with authorized/valid electronic signature
ORANGE CITY SURGERY CENTER EMPLOYEE RETIREMENT PLAN 2011 593831266 2012-04-26 ORANGE CITY SURGERY CENTER, LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3864565247
Plan sponsor’s address 975 TOWN CENTER DRIVE, SUITE 100, ORANGE CITY, FL, 32763

Plan administrator’s name and address
Administrator’s EIN 593831266
Plan administrator’s name ORANGE CITY SURGERY CENTER, LLC
Plan administrator’s address 975 TOWN CENTER DRIVE, SUITE 100, ORANGE CITY, FL, 32763
Administrator’s telephone number 3864565247

Signature of
Role Plan administrator
Date 2012-04-26
Name of individual signing KEVIN BARBER, M.D.
Valid signature Filed with authorized/valid electronic signature
ORANGE CITY SURGERY CENTER EMPLOYEE RETIREMENT PLAN 2010 593831266 2011-07-06 ORANGE CITY SURGERY CENTER, LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3864565247
Plan sponsor’s address 975 TOWN CENTER DRIVE, SUITE 100, ORANGE CITY, FL, 32763

Plan administrator’s name and address
Administrator’s EIN 593831266
Plan administrator’s name ORANGE CITY SURGERY CENTER, LLC
Plan administrator’s address 975 TOWN CENTER DRIVE, SUITE 100, ORANGE CITY, FL, 32763
Administrator’s telephone number 3864565247

Signature of
Role Plan administrator
Date 2011-07-06
Name of individual signing THOMAS M KROPP
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-06
Name of individual signing THOMAS M KROPP
Valid signature Filed with authorized/valid electronic signature
ORANGE CITY SURGERY CENTER EMPLOYEE RETIREMENT PLAN 2009 593831266 2010-09-16 ORANGE CITY SURGERY CENTER, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3864565247
Plan sponsor’s address 975 TOWN CENTER DRIVE, SUITE 100, ORANGE CITY, FL, 32763

Plan administrator’s name and address
Administrator’s EIN 593831266
Plan administrator’s name ORANGE CITY SURGERY CENTER, LLC
Plan administrator’s address 975 TOWN CENTER DRIVE, SUITE 100, ORANGE CITY, FL, 32763
Administrator’s telephone number 3864565247

Signature of
Role Plan administrator
Date 2010-09-16
Name of individual signing THOMAS M KROPP
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-16
Name of individual signing THOMAS M KROPP
Valid signature Filed with authorized/valid electronic signature
ORANGE CITY SURGERY CENTER EMPLOYEE RETIREMENT PLAN 2009 593831266 2010-09-16 ORANGE CITY SURGERY CENTER, LLC 18
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3864565247
Plan sponsor’s address 975 TOWN CENTER DRIVE, SUITE 100, ORANGE CITY, FL, 32763

Plan administrator’s name and address
Administrator’s EIN 593831266
Plan administrator’s name ORANGE CITY SURGERY CENTER, LLC
Plan administrator’s address 975 TOWN CENTER DRIVE, SUITE 100, ORANGE CITY, FL, 32763
Administrator’s telephone number 3864565247

Signature of
Role Plan administrator
Date 2010-09-16
Name of individual signing THOMAS M KROPP
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-16
Name of individual signing THOMAS M KROPP
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
CORPORATION SERVICE COMPANY Agent

Manager

Name Role Address
BALDOCK JENNIFER Manager Suite 600 340 Seven Springs Way, Brentwood, TN, 37027

Vice President

Name Role Address
O'Brien Jeff Vice President Suite 600 340 Seven Springs Way, Brentwood, TN, 37027
Doherty Dave Vice President Suite 600 340 Seven Springs Way, Brentwood, TN, 37027
Kennedy Brett Vice President Suite 600 340 Seven Springs Way, Brentwood, TN, 37027

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000002236 ORANGE CITY SURGERY CENTER EXPIRED 2014-01-07 2024-12-31 No data 310 SEVEN SPRINGS WAY, SUITE 500, BRENTWOOD, TN, 37027

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-04-20 Suite 600 340 Seven Springs Way, Brentwood, TN 37027 No data
CHANGE OF MAILING ADDRESS 2023-04-24 Suite 600 340 Seven Springs Way, Brentwood, TN 37027 No data
REGISTERED AGENT NAME CHANGED 2012-01-27 CORPORATION SERVICE COMPANY No data
REGISTERED AGENT ADDRESS CHANGED 2012-01-27 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 No data

Documents

Name Date
ANNUAL REPORT 2024-04-20
ANNUAL REPORT 2023-04-24
ANNUAL REPORT 2022-04-22
ANNUAL REPORT 2021-04-22
ANNUAL REPORT 2020-02-05
ANNUAL REPORT 2019-03-01
ANNUAL REPORT 2018-01-25
ANNUAL REPORT 2017-04-24
ANNUAL REPORT 2016-04-28
ANNUAL REPORT 2015-04-30

Related by officers

BALDOCK JENNIFER

APS OF BRADENTON, LLC BRADENTON ANESTHESIA SERVICES, LLC THE VILLAGES SURGERY CENTER, LLC ANESTHESIA MANAGEMENT SERVICES, LLC RIVERSIDE SURGICAL CENTER, LLC SURGERY PARTNERS OF MERRITT ISLAND, LLC ARMENIA AMBULATORY SURGERY CENTER, LLC NPR ANESTHESIA SERVICES, LLC SURGERY PARTNERS OF ORLANDO, LLC SURGERY PARTNERS ACQUISITION COMPANY, INC.

O'Brien Jeff

SURGERY PARTNERS OF MERRITT ISLAND, LLC ARMENIA AMBULATORY SURGERY CENTER, LLC LOGAN LABORATORIES, LLC RIVERSIDE BILLING AND MANAGEMENT COMPANY, LLC JACKSONVILLE BEACH SURGERY CENTER, LLC SPACE COAST SURGERY CENTER, LLC SURGERY PARTNERS ACQUISITION COMPANY, LLC SGRY, LLC SARC/LARGO ENDOSCOPY, LLC SURGERY PARTNERS OF MILLENIA, LLC

Doherty Dave

SURGERY PARTNERS OF MERRITT ISLAND, LLC ARMENIA AMBULATORY SURGERY CENTER, LLC LOGAN LABORATORIES, LLC RIVERSIDE BILLING AND MANAGEMENT COMPANY, LLC JACKSONVILLE BEACH SURGERY CENTER, LLC SPACE COAST SURGERY CENTER, LLC SURGERY PARTNERS ACQUISITION COMPANY, LLC SGRY, LLC SARC/LARGO ENDOSCOPY, LLC SURGERY PARTNERS OF MILLENIA, LLC

Kennedy Brett

SURGERY PARTNERS OF MERRITT ISLAND, LLC ARMENIA AMBULATORY SURGERY CENTER, LLC LOGAN LABORATORIES, LLC RIVERSIDE BILLING AND MANAGEMENT COMPANY, LLC JACKSONVILLE BEACH SURGERY CENTER, LLC SPACE COAST SURGERY CENTER, LLC SURGERY PARTNERS ACQUISITION COMPANY, LLC SGRY, LLC SARC/LARGO ENDOSCOPY, LLC SURGERY PARTNERS OF MILLENIA, LLC

Related by address

340 SEVEN SPRINGS WAY, BRENTWOOD, TN, 37027, US

RIVERSIDE SURGICAL CENTER, LLC SURGERY PARTNERS OF MERRITT ISLAND, LLC LOGAN LABORATORIES, LLC RIVERSIDE BILLING AND MANAGEMENT COMPANY, LLC SURGERY CENTER HOLDINGS, INC. SURGERY PARTNERS, INC. JACKSONVILLE BEACH SURGERY CENTER, LLC COLLIER ANESTHESIA PAIN, LLC SPACE COAST SURGERY CENTER, LLC SURGERY PARTNERS ACQUISITION COMPANY, LLC

Suite 600 340 Seven Springs Way, Brentwood, TN, 37027, US

THE SURGERY CENTER OF OCALA, LLC LAKE MARY SURGERY CENTER, L.L.C.

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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