| Entity Name: | SURGICAL CENTER OF PONTE VEDRA BEACH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 04 Sep 2014 (10 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L14000138175 |
| FEI/EIN Number | 47-2133947 |
| Address: | 1030 A1A North, Ponte Vedra Beach, FL, 32082, US |
| Mail Address: | 1030 A1A North, Ponte Vedra Beach, FL, 32082, US |
| ZIP code: | 32082 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609269232 | 2015-03-06 | 2019-07-29 | 1030 A1A N, PONTE VEDRA BEACH, FL, 320824019, US | 1030 A1A N, PONTE VEDRA BEACH, FL, 320824019, US | |||||||||||||||||||
|
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| Phone | +1 907-285-1199 |
| Fax | 9072851197 |
Authorized person
| Name | KRYSTYN COLLIER |
| Role | MANAGER |
| Phone | 9042851199 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 1215 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FARAH LAW | Agent | 6550 St. Augustine Road, Jacksonville, FL, 32217 |
| Name | Role | Address |
|---|---|---|
| Schneider Timothy LMD | Manager | 1030 A1A North, Ponte Vedra Beach, FL, 32082 |
| Harris John BMD | Manager | 1030 A1A North, Ponte Vedra Beach, FL, 32082 |
| Collier Frank RMD | Manager | 1030 A1A North, Ponte Vedra Beach, FL, 32082 |
| Hakim Farid MD | Manager | 1030 A1A North, Ponte Vedra Beach, FL, 32082 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000107895 | PONTE VEDRA BEACH SURGERY CENTER | EXPIRED | 2014-10-24 | 2024-12-31 | No data | 1030 A1A NORTH, PONTE VEDRA BEACH, FL, 32082 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-09-29 | FARAH LAW | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| LC STMNT OF AUTHORITY | 2019-10-21 | No data | No data |
| LC DISSOCIATION MEM | 2017-05-26 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-28 | 6550 St. Augustine Road, Suite 103, Jacksonville, FL 32217 | No data |
| LC AMENDMENT | 2016-09-26 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2015-02-13 | 1030 A1A North, Ponte Vedra Beach, FL 32082 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-02-13 | 1030 A1A North, Ponte Vedra Beach, FL 32082 | No data |
| Name | Date |
|---|---|
| Reg. Agent Resignation | 2022-12-27 |
| ANNUAL REPORT | 2021-04-24 |
| ANNUAL REPORT | 2020-03-17 |
| CORLCAUTH | 2019-10-21 |
| ANNUAL REPORT | 2019-02-14 |
| ANNUAL REPORT | 2018-03-04 |
| CORLCDSMEM | 2017-05-26 |
| ANNUAL REPORT | 2017-04-28 |
| AMENDED ANNUAL REPORT | 2016-12-08 |
| LC Amendment | 2016-09-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
