| Entity Name: | CITRUS ORAL AND FACIAL SURGERY AT OCALA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Sep 2017 (7 years ago) |
| Last Event: | LC AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 30 Jan 2018 (7 years ago) |
| Document Number: | L17000195986 |
| FEI/EIN Number | 82-2852923 |
| Address: | 2611 SE 17TH ST, SUITE A, OCALA, FL, 34471, US |
| Mail Address: | 6129 W. CORPORATE OAKS DRIVE, CRYSTAL RIVER, FL, 34429, US |
| ZIP code: | 34471 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326535279 | 2018-04-17 | 2023-06-21 | 2611 SE 17TH ST STE A, OCALA, FL, 344715587, US | 6129 W CORPORATE OAKS DR, CRYSTAL RIVER, FL, 344298732, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 352-509-6500 |
| Fax | 3525096556 |
| Phone | +1 352-795-4994 |
| Fax | 3527954609 |
Authorized person
| Name | MRS. MISTY C BLOMBERG |
| Role | OFFICE MANAGER |
| Phone | 5225096500 |
Taxonomy
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| License Number | DN17708 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PATEL RUSHI | Agent | 6129 W. CORPORATE OAKS DRIVE, CRYSTAL RIVER, FL, 34429 |
| Name | Role | Address |
|---|---|---|
| PATEL RUSHI | Manager | 6129 W Corporate Oaks Dr, Crystal River, FL, 34429 |
| Name | Role | Address |
|---|---|---|
| PATEL PALAK | Auth | 6129 W. CORPORATE OAKS DRIVE, CRYSTAL RIVER, FL, 34429 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000035767 | CITRUS ORAL AND FACIAL SURGERY | ACTIVE | 2018-03-16 | 2028-12-31 | No data | 2611 SE 17TH STREET, SUITE A, OCALA, FL, 34471 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT AND NAME CHANGE | 2018-01-30 | CITRUS ORAL AND FACIAL SURGERY AT OCALA, LLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-01-30 | 2611 SE 17TH ST, SUITE A, OCALA, FL 34471 | No data |
| CHANGE OF MAILING ADDRESS | 2018-01-30 | 2611 SE 17TH ST, SUITE A, OCALA, FL 34471 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-01-30 | PATEL, RUSHI | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-27 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-03-24 |
| ANNUAL REPORT | 2021-01-30 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-01-24 |
| ANNUAL REPORT | 2018-02-28 |
| LC Amendment and Name Change | 2018-01-30 |
| Florida Limited Liability | 2017-09-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
