| Entity Name: | TAMPA SURGERY CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Jan 2009 (16 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 30 Dec 2020 (4 years ago) |
| Document Number: | L09000003020 |
| FEI/EIN Number | 264008716 |
| Address: | 13904 N DALE MABRY HWY, SUITE 200, TAMPA, FL, 33618, US |
| Mail Address: | 13904 N DALE MABRY HIGHWAY, STE 200, TAMPA, FL, 33618, US |
| ZIP code: | 33618 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023256187 | 2009-01-28 | 2020-10-21 | 13904 N DALE MABRY HWY, SUITE 100, TAMPA, FL, 336182446, US | 13904 N DALE MABRY HWY, SUITE 100, TAMPA, FL, 336182446, US | |||||||||||||||||||||
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| Phone | +1 813-968-3937 |
| Fax | 8139691002 |
Authorized person
| Name | THOMAS HUNTER NEWSOM |
| Role | PRESIDENT |
| Phone | 8139683937 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | 1023256187 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WALLS AMANDA L | Agent | 225 EAST LEMON STREET, LAKELAND, FL, 33801 |
| Name | Role | Address |
|---|---|---|
| WYAM, LLC | Manager | 245 COURT STREET, CLEARWATER, FL, 33756 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-17 | 13904 N DALE MABRY HWY, SUITE 200, TAMPA, FL 33618 | No data |
| LC AMENDMENT | 2020-12-30 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-12-30 | WALLS, AMANDA L | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-12-30 | 225 EAST LEMON STREET, SUITE 300, LAKELAND, FL 33801 | No data |
| CHANGE OF MAILING ADDRESS | 2014-01-15 | 13904 N DALE MABRY HWY, SUITE 200, TAMPA, FL 33618 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-02-28 |
| ANNUAL REPORT | 2022-04-15 |
| ANNUAL REPORT | 2021-03-17 |
| LC Amendment | 2020-12-30 |
| ANNUAL REPORT | 2020-06-17 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-03-01 |
| ANNUAL REPORT | 2017-02-24 |
| ANNUAL REPORT | 2016-01-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
