| Entity Name: | DAVENPORT AMBULATORY SURGERY CENTER, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 04 Sep 2013 (11 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L13000124860 |
| FEI/EIN Number | 46-3567108 |
| Address: | 107 Park Place Blvd, Davenport, FL, 33837, US |
| Mail Address: | 107 Park Place Blvd, Davenport, FL, 33837, US |
| ZIP code: | 33837 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912378357 | 2015-10-12 | 2021-06-22 | 107 PARK PLACE BLVD, DAVENPORT, FL, 338376858, US | 107 PARK PLACE BLVD, DAVENPORT, FL, 338376858, US | |||||||||||||||
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| Phone | +1 863-419-2812 |
| Fax | 8634192821 |
Authorized person
| Name | NANCY K KASTNER |
| Role | ADMINISTRATOR |
| Phone | 4072560933 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Davenport Ambulatory Surgery Center, LLC | Agent | 107 Park Place Blvd, Davenport, FL, 33837 |
| Name | Role | Address |
|---|---|---|
| KAHLON DEVENDRA SMD | Manager | 107 PARK PLACE BLVD., DAVENPORT, FL, 33837 |
| HANZLIK ANDREW JMD | Manager | 107 PARK PLACE BLVD., DAVENPORT, FL, 33837 |
| PORTER TOM MMD | Manager | 107 PARK PLACE BLVD., DAVENPORT, FL, 33837 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-03-27 | Davenport Ambulatory Surgery Center, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-27 | 107 Park Place Blvd, Davenport, FL 33837 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-05 | 107 Park Place Blvd, Davenport, FL 33837 | No data |
| CHANGE OF MAILING ADDRESS | 2017-04-05 | 107 Park Place Blvd, Davenport, FL 33837 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000242253 | TERMINATED | 1000000989310 | POLK | 2024-04-17 | 2034-04-24 | $ 1,035.14 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LAKELAND SERVICE CENTER, 115 S MISSOURI AVE STE 202, LAKELAND FL338154644 |
| J20000066569 | TERMINATED | 1000000857073 | POLK | 2020-01-21 | 2040-01-29 | $ 1,860.27 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1415 W US HIGHWAY 90 STE 115, LAKE CITY FL320556156 |
| J19000477339 | TERMINATED | 2019CA-1550 | POLK COUNTY CIRCUIT COURT | 2019-07-11 | 2024-07-12 | $49,010.70 | NEVRO CORP., 1800 BRIDGE PARKWAY, REDWOOD CITY, CA 94065 |
| J19000584910 | LAPSED | 2019CA 000602 0000 00 | POLK CO | 2019-04-10 | 2024-09-03 | $17,103.61 | BLACK DIAMOND MEDICAL, INC, 801 RIVERS CT, ORLANDO, FLORIDA 32828 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-03-12 |
| ANNUAL REPORT | 2021-03-26 |
| ANNUAL REPORT | 2020-04-03 |
| ANNUAL REPORT | 2019-03-27 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-07-28 |
| AMENDED ANNUAL REPORT | 2015-11-03 |
| ANNUAL REPORT | 2015-01-27 |
| ANNUAL REPORT | 2014-04-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
