| Entity Name: | SURGICAL SPECIALISTS, ASC, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Dec 2006 (18 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 29 Nov 2007 (17 years ago) |
| Document Number: | L06000120455 |
| FEI/EIN Number | 208066886 |
| Address: | C/O Mark Tenholder, MD, 1034 MAR WALT DR STE 300, FORT WALTON BEACH, FL, 32547, US |
| Mail Address: | C/O Mark Tenholder, MD, 1034 MAR WALT DR STE 300, FORT WALTON BEACH, FL, 32547, US |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780871319 | 2007-09-27 | 2008-09-05 | 1034 MAR WALT DR STE 300, FORT WALTON BEACH, FL, 325476645, US | 1034 MAR WALT DR STE 300, FORT WALTON BEACH, FL, 325476645, US | |||||||||||||||
|
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| Phone | +1 850-315-9385 |
| Fax | 8503159350 |
Authorized person
| Name | SUZETTE K GRAMM |
| Role | ADMINISTRATOR |
| Phone | 8503159206 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MABRY MARIANA CFO | Agent | 1034 MAR WALT DR STE 300, FORT WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| RAGSDALE JASON C | Chief Executive Officer | 1034 MAR WALT DR STE 300, FORT WALTON BEACH, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| FT. WALTON BEACH MEDICAL CENTER, INC | Manager | 1000 MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547 |
| EMERALD COAST DIVERSIFIED, FWB, LLC | Manager | 1034 MAR WALT DRIVE SUITE 300, FORT WALTON BEACH, FL, 32547 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-30 | C/O Mark Tenholder, MD, 1034 MAR WALT DR STE 300, FORT WALTON BEACH, FL 32547 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-30 | C/O Mark Tenholder, MD, 1034 MAR WALT DR STE 300, FORT WALTON BEACH, FL 32547 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-04-27 | MABRY, MARIANA, CFO | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-04-21 | 1034 MAR WALT DR STE 300, FORT WALTON BEACH, FL 32547 | No data |
| LC NAME CHANGE | 2007-11-29 | SURGICAL SPECIALISTS, ASC, L.L.C. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-05-01 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-04-27 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
