| Entity Name: | ORTHOPAEDIC SPECIALTY CARE, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 May 2006 (19 years ago) |
| Document Number: | L06000052988 |
| FEI/EIN Number | 204857601 |
| Address: | 2131 SW 20TH PL, OCALA, FL, 34471 |
| Mail Address: | 2685 SW 32ND PL, SUITE 400, OCALA, FL, 34471 |
| ZIP code: | 34471 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427104454 | 2007-01-25 | 2011-04-11 | 2685 SW 32ND PL STE 400, OCALA, FL, 344717866, US | 2685 SW 32ND PL STE 400, OCALA, FL, 344717866, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 352-624-0004 |
| Fax | 3526243090 |
Authorized person
| Name | ANGIE OBHOLZ |
| Role | BUSINESS MANAGER |
| Phone | 3526240004 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| License Number | ME73474 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 225XH1200X - Hand Occupational Therapist |
| License Number | OT8468 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 252721900 |
| State | FL |
| Issuer | MEDICARE RAILROAD |
| Number | DF7751 |
| Name | Role | Address |
|---|---|---|
| KRUEGER SCOTT D | Agent | 2750 NW 43RD STREET SUITE 201, GAINESVILLE, FL, 32606 |
| Name | Role | Address |
|---|---|---|
| MANSEAU CHRISTOPHER | Manager | 2685 SW 32ND PL, SUITE 400, OCALA, FL, 34471 |
| Name | Role | Address |
|---|---|---|
| MANSEAU ANGIE | Managing Member | 2685 SW 32ND PL, SUITE 400, OCALA, FL, 34471 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2011-04-21 | 2131 SW 20TH PL, OCALA, FL 34471 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-09-10 | 2131 SW 20TH PL, OCALA, FL 34471 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-03-24 |
| ANNUAL REPORT | 2021-04-21 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-01-10 |
| ANNUAL REPORT | 2017-03-31 |
| ANNUAL REPORT | 2016-02-04 |
| ANNUAL REPORT | 2015-04-17 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
