| Entity Name: | DAVENPORT AMBULATORY SURGERY CENTER, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
DAVENPORT AMBULATORY SURGERY CENTER, L.L.C. 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. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 04 Sep 2013 (12 years ago) |
| Date of dissolution: | 22 Sep 2023 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (2 years ago) |
| Document Number: | L13000124860 |
| FEI/EIN Number |
46-3567108
Federal Employer Identification (FEI) Number assigned by the IRS. |
| 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 |
|---|---|---|
| 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 |
| Davenport Ambulatory Surgery Center, LLC | Agent | 107 Park Place Blvd, Davenport, FL, 33837 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | - | - |
| REGISTERED AGENT NAME CHANGED | 2019-03-27 | Davenport Ambulatory Surgery Center, LLC | - |
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-27 | 107 Park Place Blvd, Davenport, FL 33837 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-05 | 107 Park Place Blvd, Davenport, FL 33837 | - |
| CHANGE OF MAILING ADDRESS | 2017-04-05 | 107 Park Place Blvd, Davenport, FL 33837 | - |
| 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 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4690867108 | 2020-04-13 | 0455 | PPP | 107 Park Place Boulevard N/A, DAVENPORT, FL, 33837-6858 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 May 2025
Sources: Florida Department of State
