| Entity Name: | HABANA AMBULATORY SURGERY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Sep 2015 (9 years ago) |
| Document Number: | L15000161431 |
| FEI/EIN Number | 47-5162374 |
| Address: | 501 N. Reo Street, TAMPA, FL, 33609, US |
| Mail Address: | 501 N. Reo Street, TAMPA, FL, 33609, US |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578917035 | 2016-04-20 | 2023-06-26 | PO BOX 628766, ORLANDO, FL, 328628766, US | 4726 N HABANA AVE STE 100, TAMPA, FL, 336147144, US | |||||||||||||||||||||||
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| Phone | +1 813-549-2134 |
| Fax | 8135691759 |
| Phone | +1 813-769-8855 |
| Fax | 8135140231 |
Authorized person
| Name | JOSHUA HELMS |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 8135492134 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 282N00000X - General Acute Care Hospital |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Wood David | Agent | 504 N. REO ST., TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| Helms Josh | Chief Executive Officer | 504 N. REO ST., TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| Gari Tracie | Chief Administrative Officer | 504 N. REO ST., TAMPA, FL, 33609 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-05-24 | 501 N. Reo Street, TAMPA, FL 33609 | No data |
| CHANGE OF MAILING ADDRESS | 2023-05-24 | 501 N. Reo Street, TAMPA, FL 33609 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-03-14 | Wood, David | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-26 | 504 N. REO ST., TAMPA, FL 33609 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-03-14 |
| ANNUAL REPORT | 2022-03-30 |
| ANNUAL REPORT | 2021-03-12 |
| ANNUAL REPORT | 2020-06-26 |
| ANNUAL REPORT | 2019-04-07 |
| ANNUAL REPORT | 2018-04-22 |
| ANNUAL REPORT | 2017-02-20 |
| ANNUAL REPORT | 2016-04-08 |
| Florida Limited Liability | 2015-09-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
