| Entity Name: | PANHANDLE SURGICAL SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 29 Aug 2016 (8 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L16000164235 |
| FEI/EIN Number | 81-3849707 |
| Address: | 801 East 6th Street, suite 202, PANAMA CITY, FL, 32401, US |
| Mail Address: | 9132 Resota Beach Rd, PANAMA CITY, FL, 32409, US |
| ZIP code: | 32401 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184173338 | 2016-09-29 | 2017-03-28 | 2202 STATE AVE, STE 104, PANAMA CITY, FL, 324057601, US | 2202 STATE AVE, STE 104, PANAMA CITY, FL, 324057601, US | |||||||||||||||||||||||
|
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| Phone | +1 850-640-3320 |
Authorized person
| Name | MS. DOTTIE CLARK |
| Role | MANAGER |
| Phone | 8506403320 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | ME102627 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL PROVIDER NPI |
| Number | 1528213394 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| THOMAS JOHN B | Agent | 801 East 6th Street, PANAMA CITY, FL, 32401 |
| Name | Role | Address |
|---|---|---|
| THOMAS JOHN B | Manager | 2202 STATE AVENUE, PANAMA CITY, FL, 32405 |
| Name | Role | Address |
|---|---|---|
| WOODLEY HELENE | Authorized Member | 2202 STATE AVENUE, PANAMA CITY, FL, 32405 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-26 | 801 East 6th Street, suite 202, PANAMA CITY, FL 32401 | No data |
| CHANGE OF MAILING ADDRESS | 2018-03-26 | 801 East 6th Street, suite 202, PANAMA CITY, FL 32401 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-03-26 | 801 East 6th Street, Suite 202, PANAMA CITY, FL 32401 | No data |
| LC AMENDMENT | 2016-10-31 | No data | No data |
| LC AMENDMENT | 2016-10-05 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-03-06 |
| LC Amendment | 2016-10-31 |
| LC Amendment | 2016-10-05 |
| Florida Limited Liability | 2016-08-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
