| Entity Name: | PARK MEDICAL SURGERY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 02 Jan 2007 (18 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | L07000000224 |
| FEI/EIN Number | 208140515 |
| Address: | 5000 PARK STREET NORTH, SUITE 1101, ST. PETERSBURG, FL, 33709, US |
| Mail Address: | 5000 PARK STREET NORTH, SUITE 1101, ST. PETERSBURG, FL, 33709, US |
| ZIP code: | 33709 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942347489 | 2007-02-01 | 2009-10-23 | 5000 PARK STREET NORTH, SUITE 1101, ST. PETERSBURG, FL, 337092221, US | 5000 PARK STREET NORTH, SUITE 1101, ST. PETERSBURG, FL, 337092221, US | |||||||||||||||||||||||||
|
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| Phone | +1 727-544-5444 |
| Fax | 7275445441 |
Authorized person
| Name | MR. KIRIT DESAI |
| Role | PRESIDENT/MANAGING MEMBER |
| Phone | 7275445444 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 1221 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA - ASC LICENSE |
| Number | 1221 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DESAI KIRIT S | Agent | 5000 PARK STREET NORTH, ST. PETERSBURG, FL, 33709 |
| Name | Role | Address |
|---|---|---|
| DESAI KIRIT S | Manager | 5000 PARK STREET NORTH, SUITE 1101, ST. PETERSBURG,, FL, 33709 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-01-12 | 5000 PARK STREET NORTH, SUITE 1101, ST. PETERSBURG, FL 33709 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-01-12 | 5000 PARK STREET NORTH, SUITE 1101, ST. PETERSBURG, FL 33709 | No data |
| REINSTATEMENT | 2009-01-12 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2009-01-12 | 5000 PARK STREET NORTH, SUITE 1101, ST. PETERSBURG, FL 33709 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-01-12 | DESAI, KIRIT S | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-02-16 |
| REINSTATEMENT | 2009-01-12 |
| Florida Limited Liability | 2007-01-02 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
