| Entity Name: | ADVANCED LAPAROSCOPIC SURGERY OF FORT MYERS, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 21 May 2007 (18 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 years ago) |
| Document Number: | L07000053486 |
| FEI/EIN Number | 260204104 |
| Address: | 615 WILLIAMS AVE,, SUITE 101, LEHIGH ACRES, FL, 33972, US |
| Mail Address: | 615 WILLIAMS AVE,, SUITE 101, LEHIGH ACRES, FL, 33972, US |
| ZIP code: | 33972 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780874784 | 2007-07-26 | 2009-07-23 | 615 WILLIAMS AVE, SUITE 101, LEHIGH ACRES, FL, 339727954, US | 615 WILLIAMS AVE, SUITE 101, LEHIGH ACRES, FL, 339727954, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 239-209-7543 |
| Fax | 8665866004 |
| Phone | +1 239-303-5273 |
Authorized person
| Name | DR. PATRICK THOMAS MCGRAW |
| Role | OWNER |
| Phone | 2392097543 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | ME96681 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | HUMANA |
| Number | 178150564104 |
| State | FL |
| Issuer | CIGNA |
| Number | 3954998 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 18294 |
| State | FL |
| Issuer | UNITED |
| Number | 2822788 |
| State | FL |
| Issuer | AETNA |
| Number | 9344077 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MCGRAW PATRICK | Agent | 615 WILLIAMS AVE., LEHIGH ACRES, FL, 33972 |
| Name | Role | Address |
|---|---|---|
| MCGRAW PATRICK | Managing Member | 615 WILLIAMS AVE., SUITE 101, LEHIGH ACRES, FL, 33972 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-02-04 | 615 WILLIAMS AVE,, SUITE 101, LEHIGH ACRES, FL 33972 | No data |
| CHANGE OF MAILING ADDRESS | 2009-02-04 | 615 WILLIAMS AVE,, SUITE 101, LEHIGH ACRES, FL 33972 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-02-04 | 615 WILLIAMS AVE., SUITE 101, LEHIGH ACRES, FL 33972 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2009-02-04 |
| ANNUAL REPORT | 2008-03-05 |
| Florida Limited Liability | 2007-05-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
