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  5. RIVERWALK AMBULATORY SURGERY CENTER, LLC

RIVERWALK AMBULATORY SURGERY CENTER, LLC

Company Details

Entity Name: RIVERWALK AMBULATORY SURGERY CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 25 Jul 2007 (17 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 15 Mar 2021 (4 years ago)
Document Number: L07000076816
FEI/EIN Number 260594903
Address: 200 THIRD AVENUE WEST, SUITE 170, BRADENTON, FL, 34205, US
Mail Address: 200 THIRD AVENUE WEST, SUITE 170, BRADENTON, FL, 34205, US
ZIP code: 34205
County: Manatee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1588839609 2008-04-29 2018-12-04 200 3RD AVE W STE 170, BRADENTON, FL, 342058632, US 200 3RD AVE W., STE 170, BRADENTON, FL, 342058632, US

Contacts
Phone +1 941-782-5439
Fax 9417825438
Phone +1 941-782-5434

Authorized person
Name MRS. ALLISON L WAKELAND
Role BILLING MANAGER
Phone 9412163964

Taxonomy
Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
State FL
Is Primary No
Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
License Number 1304
State FL
Is Primary Yes
Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 11918800
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
RIVERWALK AMBULATORY SURGERY CENTER 401(K) PLAN 2023 260594903 2024-07-09 RIVERWALK AMBULATORY SURGERY CENTER, LLC 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621493
Sponsor’s telephone number 9417825439
Plan sponsor’s address 200 3RD AVENUE WEST, STE 170, BRADENTON, FL, 34205
RIVERWALK AMBULATORY SURGERY CENTER 401(K) PLAN 2022 260594903 2023-08-14 RIVERWALK AMBULATORY SURGERY CENTER, LLC 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621493
Sponsor’s telephone number 9417825439
Plan sponsor’s address 200 3RD AVENUE WEST, STE 170, BRADENTON, FL, 34205
RIVERWALK AMBULATORY SURGERY CENTER 401(K) PLAN 2021 260594903 2022-10-17 RIVERWALK AMBULATORY SURGERY CENTER 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621493
Sponsor’s telephone number 9417943118
Plan sponsor’s address 200 3RD AVENUE WEST, SUITE 170, BRADENTON, FL, 34205
RIVERWALK AMBULATORY SURGERY CENTER 401(K) PLAN 2021 260594903 2022-10-17 RIVERWALK AMBULATORY SURGERY CENTER 35
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621493
Sponsor’s telephone number 9417943118
Plan sponsor’s address 200 3RD AVENUE WEST, SUITE 170, BRADENTON, FL, 34205
RIVERWALK AMBULATORY SURGERY CENTER 401(K) PLAN 2020 260594903 2021-05-05 RIVERWALK AMBULATORY SURGERY CENTER 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621493
Sponsor’s telephone number 9417943118
Plan sponsor’s address 200 3RD AVENUE WEST, SUITE 170, BRADENTON, FL, 34205
RIVERWALK AMBULATORY SURGERY CENTER 401(K) PLAN 2019 260594903 2020-09-17 RIVERWALK AMBULATORY SURGERY CENTER 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621493
Sponsor’s telephone number 9417943118
Plan sponsor’s address 200 3RD AVENUE WEST, SUITE 200, BRADENTON, FL, 34205
RIVERWALK AMBULATORY SURGERY CENTER 401(K) PLAN 2018 260594903 2019-03-15 RIVERWALK AMBULATORY SURGERY CENTER 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621493
Sponsor’s telephone number 9417943118
Plan sponsor’s address 200 3RD AVENUE WEST, SUITE 200, BRADENTON, FL, 34205
RIVERWALK AMBULATORY SURGERY CENTER 401(K) PLAN 2017 260594903 2018-07-13 RIVERWALK AMBULATORY SURGERY CENTER 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621493
Sponsor’s telephone number 9417943118
Plan sponsor’s address 200 3RD AVENUE WEST, SUITE 200, BRADENTON, FL, 34205

Signature of
Role Plan administrator
Date 2018-07-13
Name of individual signing LINDA REEVES
Valid signature Filed with authorized/valid electronic signature
RIVERWALK AMBULATORY SURG CNTR 401K PLAN 2016 260594903 2017-06-08 RIVERWALK AMBULATORY SURGERY CENTER 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621493
Sponsor’s telephone number 9417943118
Plan sponsor’s address 200 3RD AVE W STE 200, BRADENTON, FL, 34205

Signature of
Role Plan administrator
Date 2017-06-08
Name of individual signing LINDA M REEVES
Valid signature Filed with authorized/valid electronic signature
RIVERWALK AMBULATORY SURG CNTR 401K PLAN 2015 260594903 2016-06-07 RIVERWALK AMBULATORY SURGERY CENTER 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621493
Sponsor’s telephone number 9417943118
Plan sponsor’s address 200 3RD AVE W STE 200, BRADENTON, FL, 34205

Signature of
Role Plan administrator
Date 2016-06-07
Name of individual signing LINDA REEVES
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WALKER GARY ESQUIRE Agent 401 E. JACKSON STREET, TAMPA, FL, 33602

Manager

Name Role Address
KING MICHAEL A Manager 200 3RD AVE W, SUITE 200, BRADENTON, FL, 34205
TALLY PHILIP W Manager 200 3RD AVE W, SUITE 200, BRADENTON, FL, 34205
MILLER ALAN K Manager 200 3RD AVE W, SUITE 210, BRADENTON, FL, 34205
HERRMAN EDWARD Manager 200 3RD AVE W, SUITE 210, BRADENTON, FL, 34205

Admi

Name Role Address
Branon James F Admi 200 THIRD AVENUE WEST, BRADENTON, FL, 34205

Events

Event Type Filed Date Value Description
LC STMNT OF RA/RO CHG 2021-03-15 No data No data
REGISTERED AGENT ADDRESS CHANGED 2021-03-15 401 E. JACKSON STREET, SUITE 3100, TAMPA, FL 33602 No data
CHANGE OF PRINCIPAL ADDRESS 2016-08-26 200 THIRD AVENUE WEST, SUITE 170, BRADENTON, FL 34205 No data
CHANGE OF MAILING ADDRESS 2016-08-26 200 THIRD AVENUE WEST, SUITE 170, BRADENTON, FL 34205 No data

Documents

Name Date
ANNUAL REPORT 2024-03-04
ANNUAL REPORT 2023-02-06
ANNUAL REPORT 2022-04-11
CORLCRACHG 2021-03-15
ANNUAL REPORT 2021-02-08
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-04-19
ANNUAL REPORT 2018-02-19
ANNUAL REPORT 2017-02-14
ANNUAL REPORT 2016-01-28

Related by officers

KING MICHAEL A

TALES UNTOLD BAND/BIGGSOUND PRODUCTIONS LLC NETSIRK GLOBAL FINANCE INC. MICHAEL KING SERVICES INC. STRAIGHT LINE CURB & STRIPING INC. NEURO/SPINAL ASSOCIATES, P.A. M.B. KING INC. MAK ROOFING & WATERPROOFING, INC. D.C. TAYLOR CO. BRAVO MORTGAGE AND FINANCIAL SERVICES, INC. MUSCULOSKELETAL REHABILITATION SERVICES, INC.

TALLY PHILIP W

GULF COAST HIE, INC.

MILLER ALAN K

MANATEE MEDICAL RESEARCH INSTITUTE, LLC

HERRMAN EDWARD

UROLOGY PARTNERS OF MANATEE, LLC

WALKER GARY ESQUIRE

MGA PRO, LLC

Related by address

No related companies by address

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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