| Entity Name: | PUMPKIN PATCH AMBULATORY SURGICAL CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 11 Sep 2015 (9 years ago) |
| Document Number: | L15000155155 |
| FEI/EIN Number | 47-5078896 |
| Address: | 1500 S ORLANDO AVENUE, WINTER PARK, FL, 32789, US |
| Mail Address: | 1500 S ORLANDO AVENUE, WINTER PARK, FL, 32789, US |
| ZIP code: | 32789 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295258416 | 2017-07-19 | 2024-04-17 | 1500 S ORLANDO AVE STE 100, WINTER PARK, FL, 327895500, US | 1500 S ORLANDO AVE, WINTER PARK, FL, 327895500, US | |||||||||||||||||
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| Phone | +1 407-740-0909 |
| Fax | 4078213489 |
| Fax | 4077561605 |
Authorized person
| Name | RANDALL A LOY |
| Role | PHYSICIAN/OWNER |
| Phone | 4077400909 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HARARY LEE | Agent | 1244 MAYFIELD AVE., WINTER PARK, FL, 32789 |
| Name | Role | Address |
|---|---|---|
| LOY RANDALL | Manager | 1500 S ORLANDO AVENUE, WINTER PARK, FL, 32789 |
| JAFFE SHARON | Manager | 1244 MAYFIELD AVE., WINTER PARK, FL, 32789 |
| Name | Role | Address |
|---|---|---|
| harary lee | mgr | 1244 MAYFIELD AVE., WINTER PARK, FL, 32789 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000077514 | ORLANDO AVENUE SURGERY CENTER, LLC | ACTIVE | 2017-07-19 | 2027-12-31 | No data | 1500 S ORLANDO AVE, SUITE 100, WINTER PARK, FL, 32789 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-04 | 1500 S ORLANDO AVENUE, SUITE 200, WINTER PARK, FL 32789 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-04 | 1500 S ORLANDO AVENUE, SUITE 200, WINTER PARK, FL 32789 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2022-03-21 |
| ANNUAL REPORT | 2021-04-06 |
| ANNUAL REPORT | 2020-02-12 |
| ANNUAL REPORT | 2019-02-19 |
| ANNUAL REPORT | 2018-03-03 |
| ANNUAL REPORT | 2017-03-28 |
| ANNUAL REPORT | 2016-04-21 |
| Florida Limited Liability | 2015-09-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
