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LAKE CITY SURGERY CENTER, LLC - Florida Company Profile

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Company Details

Entity Name: LAKE CITY SURGERY CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 29 Aug 2007 (18 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 21 Jun 2011 (14 years ago)
Document Number: L07000088906
FEI/EIN Number 260811545
Address: 208 SW PROSPERITY PLACE, LAKE CITY, FL, 32024, US
Mail Address: 208 SW PROSPERITY PLACE, LAKE CITY, FL, 32024, US
ZIP code: 32024
City: Lake City
County: Columbia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Thanawala RIZWANA Dr. Managing Member 6614 nw 50th lane, gainesville, FL, 32653
THANAWALA RIZWANA Agent 4367 NW AMERICAN LANE, LAKE CITY, FL, 32055

National Provider Identifier

NPI Number:
1598965634

Authorized Person:

Name:
DERENDA TIMBERLAKE
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
3864873935

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2017-01-13 208 SW PROSPERITY PLACE, LAKE CITY, FL 32024 -
CHANGE OF MAILING ADDRESS 2017-01-13 208 SW PROSPERITY PLACE, LAKE CITY, FL 32024 -
LC AMENDMENT 2011-06-21 - RECEIVED COURT ORDER LAYING ASIDE D ISSOLUTION - SEE IMAGE
REGISTERED AGENT ADDRESS CHANGED 2010-04-05 4367 NW AMERICAN LANE, LAKE CITY, FL 32055 -
LC VOLUNTARY DISSOLUTION 2010-04-05 - -
LC AMENDMENT 2009-03-16 - -
REGISTERED AGENT NAME CHANGED 2009-03-16 THANAWALA, RIZWANA -

Documents

Name Date
ANNUAL REPORT 2024-04-13
ANNUAL REPORT 2023-04-01
ANNUAL REPORT 2022-04-29
ANNUAL REPORT 2021-04-09
ANNUAL REPORT 2020-05-24
ANNUAL REPORT 2019-04-08
ANNUAL REPORT 2018-04-18
ANNUAL REPORT 2017-01-13
ANNUAL REPORT 2016-03-15
ANNUAL REPORT 2015-01-07

USAspending Awards / Financial Assistance

Date:
2021-02-05
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
48800.00
Total Face Value Of Loan:
48800.00
Date:
2020-04-09
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
49000.00
Total Face Value Of Loan:
49000.00
Date:
2020-04-09
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
49000.00
Total Face Value Of Loan:
49000.00

OSHA's Inspections within Industry

Inspection Summary

Date:
2013-03-14
Type:
Planned
Address:
404 HALL OF FAME DR., LAKE CITY, FL, 32055
Safety Health:
Health
Scope:
Complete

Paycheck Protection Program

Jobs Reported:
11
Initial Approval Amount:
$48,800
Date Approved:
2021-02-05
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$48,800
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$49,115.84
Servicing Lender:
First Federal Bank
Use of Proceeds:
Payroll: $48,797
Utilities: $1
Jobs Reported:
14
Initial Approval Amount:
$49,000
Date Approved:
2020-04-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$49,000
Race:
Asian
Ethnicity:
Not Hispanic or Latino
Gender:
Female Owned
Veteran:
Unanswered
Forgiveness Amount:
$49,387.92
Servicing Lender:
First Federal Bank
Use of Proceeds:
Payroll: $49,000

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Date of last update: 02 Aug 2025

Sources: Florida Department of State