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DAVENPORT AMBULATORY SURGERY CENTER, L.L.C. - Florida Company Profile

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Company Details

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.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

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
City: Davenport
County: Polk
Place of Formation: FLORIDA

Key Officers & Management

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

National Provider Identifier

NPI Number:
1912378357
Certification Date:
2021-06-22

Authorized Person:

Name:
NANCY K KASTNER
Role:
ADMINISTRATOR
Phone:

Taxonomy:

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

Contacts:

Fax:
8634192821

Events

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 -

Debts

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

Documents

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

USAspending Awards / Financial Assistance

Date:
2021-02-09
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:
143708.00
Total Face Value Of Loan:
143708.00
Date:
2020-04-13
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:
195500.00
Total Face Value Of Loan:
195500.00

Paycheck Protection Program

Jobs Reported:
18
Initial Approval Amount:
$195,500
Date Approved:
2020-04-13
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$195,500
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$197,878.58
Servicing Lender:
SouthState Bank, National Association
Use of Proceeds:
Payroll: $195,500
Jobs Reported:
22
Initial Approval Amount:
$143,708
Date Approved:
2021-02-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$143,708
Race:
White
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$144,534.32
Servicing Lender:
SouthState Bank, National Association
Use of Proceeds:
Payroll: $143,706
Utilities: $1

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Date of last update: 01 Jul 2025

Sources: Florida Department of State