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PINELLAS SURGERY CENTER, LLC - Florida Company Profile

Company Details

Entity Name: PINELLAS SURGERY CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

PINELLAS SURGERY CENTER, LLC 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: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 21 Jan 2016 (9 years ago)
Last Event: CONVERSION
Event Date Filed: 21 Jan 2016 (9 years ago)
Document Number: L16000011840
FEI/EIN Number 752563226

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 4650 4TH ST N, ST PETERSBURG, FL, 33703, US
Mail Address: 1414 Kuhl Ave., MP 2, Orlando, FL, 32806, US
ZIP code: 33703
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1003870825 2006-04-17 2020-10-09 4650 4TH ST N, ST PETERSBURG, FL, 337033802, US 4650 4TH ST N, ST PETERSBURG, FL, 337033802, US

Contacts

Phone +1 727-527-1919
Fax 7275270714

Authorized person

Name SHANNON BRANGERS
Role ADMINISTRATOR
Phone 7275271919

Taxonomy

Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
License Number 878
State FL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 079205500
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PINELLAS SURGERY CENTER LLC 401(K) PROFIT SHARING PLAN & TRUST 2022 752563226 2023-06-01 PINELLAS SURGERY CENTER LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 7275271919
Plan sponsor’s address 4650 4TH ST N, ST PETERSBURG, FL, 33703

Signature of

Role Plan administrator
Date 2023-06-01
Name of individual signing SHANNON BRANGERS
Valid signature Filed with authorized/valid electronic signature
PINELLAS SURGERY CENTER LLC 401(K) PROFIT SHARING PLAN & TRUST 2021 752563226 2022-03-30 PINELLAS SURGERY CENTER LLC 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 7275271919
Plan sponsor’s address 4650 4TH ST N, ST PETERSBURG, FL, 33703

Signature of

Role Plan administrator
Date 2022-03-30
Name of individual signing SHANNON BRANGERS
Valid signature Filed with authorized/valid electronic signature
PINELLAS SURGERY CENTER LLC 401(K) PROFIT SHARING PLAN & TRUST 2020 752563226 2021-04-05 PINELLAS SURGERY CENTER LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 7275271919
Plan sponsor’s address 4650 4TH ST N, ST PETERSBURG, FL, 33703

Signature of

Role Plan administrator
Date 2021-04-05
Name of individual signing SHANNON BRANGERS
Valid signature Filed with authorized/valid electronic signature
PINELLAS SURGERY CENTER LLC 401(K) PROFIT SHARING PLAN & TRUST 2019 752563226 2020-06-29 PINELLAS SURGERY CENTER LLC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 7275271919
Plan sponsor’s address 4650 4TH ST N, ST PETERSBURG, FL, 33703

Signature of

Role Plan administrator
Date 2020-06-29
Name of individual signing SHANNON BRANGERS
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
OH Ambulatory Serivces Management, LLC Manager 1414 Kuhl Ave., MP 2, Orlando, FL, 32806
CANIZARES GEORGE MD Auth 4650 4TH ST N, ST PETERSBURG, FL, 33703
Burns Jennifer MD Auth 4650 4TH ST N, ST PETERSBURG, FL, 33703
Pagano Paul MD Auth 4650 4TH ST N, ST PETERSBURG, FL, 33703
Ohe Greg MD Auth 1414 KUHL AVE, ORLANDO, FL, 32806
Smith Joseph Auth 1414 KUHL AVE, ORLANDO, FL, 32806
Zika Ryan Agent 207 W. Gore St., Suite 201, ORLANDO, FL, 32806

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G98138900020 CENTER FOR SPECIAL SURGERY ACTIVE 1998-05-18 2028-12-31 - 4650 4TH STREET NORTH, ST. PETERSBURG, FL, 33703

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2025-04-01 4650 4TH ST N, ST PETERSBURG, FL 33703 -
CHANGE OF PRINCIPAL ADDRESS 2024-04-01 4650 4TH ST N, ST PETERSBURG, FL 33703 -
CHANGE OF MAILING ADDRESS 2022-03-16 4650 4TH ST N, ST PETERSBURG, FL 33703 -
REGISTERED AGENT ADDRESS CHANGED 2022-03-16 207 W. Gore St., Suite 201, ORLANDO, FL 32806 -
REGISTERED AGENT NAME CHANGED 2021-03-26 Zika, Ryan -
CONVERSION 2016-01-21 - CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS A94000001415. CONVERSION NUMBER 700000157887

Documents

Name Date
ANNUAL REPORT 2024-02-08
ANNUAL REPORT 2023-04-06
ANNUAL REPORT 2022-03-16
ANNUAL REPORT 2021-03-26
ANNUAL REPORT 2020-01-17
ANNUAL REPORT 2019-04-25
ANNUAL REPORT 2018-01-15
ANNUAL REPORT 2017-04-24
Florida Limited Liability 2016-01-21

Date of last update: 01 Mar 2025

Sources: Florida Department of State