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  5. SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA LLC

SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA LLC - Florida Company Profile

Company Details

Entity Name: SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 10 Sep 2008 (17 years ago)
Document Number: L08000086327
FEI/EIN Number 263371656

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 4519 TILTON COURT, FORT MYERS, FL, 33907
Mail Address: 4519 TILTON COURT, FORT MYERS, FL, 33907, US
ZIP code: 33907
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1780835959 2008-10-07 2024-06-04 4519 TILTON CT, FORT MYERS, FL, 339071214, US 4519 TILTON CT, FORT MYERS, FL, 339071214, US

Contacts
Phone +1 239-494-8777
Fax 2392887139

Authorized person
Name DR. THOMAS L BASS
Role PRESIDENT
Phone 2394948777

Taxonomy
Taxonomy Code 208600000X - Surgery Physician
License Number ME66691
State FL
Is Primary Yes

Other Provider Identifiers
Issuer PTAN
Number EU499A
State FL
Issuer MEDICAID
Number 003437100
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SURGICAL CONSULTANTS OF HOLLYWOOD, P.A. PROFIT SHARING PLAN 2023 263371656 2024-07-24 SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2394948777
Plan sponsor’s address 4519 TILTON COURT, FORT MYERS, FL, 33907
SURGICAL CONSULTANTS OF HOLLYWOOD, P.A. PROFIT SHARING PLAN 2022 263371656 2023-04-24 SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2394948777
Plan sponsor’s address 4519 TILTON COURT, FORT MYERS, FL, 33907
SURGICAL CONSULTANTS OF HOLLYWOOD, P.A. PROFIT SHARING PLAN 2021 263371656 2022-05-19 SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2394948777
Plan sponsor’s address 4519 TILTON COURT, FORT MYERS, FL, 33907
SURGICAL CONSULTANTS OF HOLLYWOOD, P.A. PROFIT SHARING PLAN 2020 263371656 2021-05-25 SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2394948777
Plan sponsor’s address 4519 TILTON COURT, FORT MYERS, FL, 33907
SURGICAL CONSULTANTS OF HOLLYWOOD, P.A. PROFIT SHARING PLAN 2019 263371656 2020-05-11 SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2394948777
Plan sponsor’s address 4519 TILTON COURT, FORT MYERS, FL, 33907
SURGICAL CONSULTANTS OF HOLLYWOOD, P.A. PROFIT SHARING PLAN 2018 263371656 2019-05-23 SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2394948777
Plan sponsor’s address 4519 TILTON COURT, FORT MYERS, FL, 33907
SURGICAL CONSULTANTS OF HOLLYWOOD, P.A. PROFIT SHARING PLAN 2017 263371656 2018-07-20 SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2394948777
Plan sponsor’s address 4519 TILTON COURT, FORT MYERS, FL, 33907

Signature of
Role Plan administrator
Date 2018-07-20
Name of individual signing THOMAS BASS, M.D.
Valid signature Filed with authorized/valid electronic signature
SURGICAL CONSULTANTS OF HOLLYWOOD, P.A. PROFIT SHARING PLAN 2016 263371656 2017-07-19 SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2394948777
Plan sponsor’s address 4519 TILTON COURT, FORT MYERS, FL, 33907

Signature of
Role Plan administrator
Date 2017-07-19
Name of individual signing THOMAS BASS, M.D.
Valid signature Filed with authorized/valid electronic signature
SURGICAL CONSULTANTS OF HOLLYWOOD, P.A. PROFIT SHARING PLAN 2015 263371656 2016-10-03 SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2394948777
Plan sponsor’s address 4519 TILTON COURT, FORT MYERS, FL, 33907

Signature of
Role Plan administrator
Date 2016-10-03
Name of individual signing THOMAS BASS, M.D.
Valid signature Filed with authorized/valid electronic signature
SURGICAL CONSULTANTS OF HOLLYWOOD, P.A. PROFIT SHARING PLAN 2014 263371656 2015-07-07 SURGICAL CONSULTANTS OF SOUTHWEST FLORIDA, LLC 6
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2394948777
Plan sponsor’s address 4519 TILTON COURT, FORT MYERS, FL, 33907

Signature of
Role Plan administrator
Date 2015-07-07
Name of individual signing THOMAS BASS, M.D.
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
BASS THOMAS Managing Member 4519 TILTON COURT, FORT MYERS, FL, 33907
Bass Tiffany E Manager 4519 TILTON COURT, FORT MYERS, FL, 33907
BASS THOMAS Agent 4519 TILTON COURT, FORT MYERS, FL, 33907

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G09000141293 GULF COAST BARIATRICS EXPIRED 2009-08-03 2014-12-31 - 1150 N 35TH AVE STE 540, HOLLYWOOD, FL, 33021

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2013-02-13 4519 TILTON COURT, FORT MYERS, FL 33907 -
REGISTERED AGENT ADDRESS CHANGED 2013-02-13 4519 TILTON COURT, FORT MYERS, FL 33907 -
CHANGE OF PRINCIPAL ADDRESS 2011-01-10 4519 TILTON COURT, FORT MYERS, FL 33907 -

Documents

Name Date
ANNUAL REPORT 2024-03-20
ANNUAL REPORT 2023-02-08
ANNUAL REPORT 2022-03-11
ANNUAL REPORT 2021-02-22
ANNUAL REPORT 2020-03-04
ANNUAL REPORT 2019-04-15
ANNUAL REPORT 2018-03-12
ANNUAL REPORT 2017-03-13
ANNUAL REPORT 2016-02-18
ANNUAL REPORT 2015-02-04

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9617037200 2020-04-28 0455 PPP 4519 TILTON CT, FORT MYERS, FL, 33907
Loan Status Date 2021-05-14
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 42700
Loan Approval Amount (current) 42700
Undisbursed Amount 0
Franchise Name -
Lender Location ID 51009
Servicing Lender Name First-Citizens Bank & Trust Company
Servicing Lender Address 100 E. Tryon Rd DAC - 90, Raleigh, NC, 27603-3581
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description New Business or 2 years or less
Project Address FORT MYERS, LEE, FL, 33907-1000
Project Congressional District FL-19
Number of Employees 3
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 51009
Originating Lender Name First-Citizens Bank & Trust Company
Originating Lender Address Raleigh, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 43095.41
Forgiveness Paid Date 2021-04-08

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SPACE COAST SIZZLE, LLC - Inactive
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THE BROWNSTONE BUILDERS COMPANY INC. - Inactive
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GCB ENTERPRISES, LLC - Active
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BASS FLOORING SERVICES, INC. - Inactive
Domestic Profit (2003 - 2005)

Companies related by address

4519 TILTON COURT, FORT MYERS, FL, 33907

GCB ENTERPRISES, LLC

Date of last update: 02 Apr 2025

Sources: Florida Department of State

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