| Entity Name: | SUMMERPORT SURGERY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 15 Nov 2017 (7 years ago) |
| Document Number: | L17000236425 |
| FEI/EIN Number | 37-1877771 |
| Address: | 5151 Winter Garden Vineland Rd., Suite 108, Windermere, FL, 34786, US |
| Mail Address: | 102 W. Pineloch Ave., Suite 23, Orlando, FL, 32806, US |
| ZIP code: | 34786 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942775762 | 2018-10-08 | 2018-10-08 | 5151 WINTER GARDEN VINELAND RD, WINDERMERE, FL, 347866098, US | 5151 WINTER GARDEN VINELAND RD, WINDERMERE, FL, 347866098, US | |||||||||||||
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| Phone | +1 321-841-8199 |
Authorized person
| Name | DR. HECTOR RAMIREZ |
| Role | OFFICER |
| Phone | 4073066386 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Zika Ryan | Agent | 207 W Gore St., Suite 201, ORLANDO, FL, 32806 |
| Name | Role | Address |
|---|---|---|
| Mastali MD Reza | Auth | 1414 KUHL AVE, ORLANDO, FL, 32806 |
| Ramirez MD Hector | Auth | 1414 KUHL AVE, ORLANDO, FL, 32806 |
| Edwards MD Troy | Auth | 1414 KUHL AVE, ORLANDO, FL, 32806 |
| Koovakada Philip | Auth | 1414 KUHL AVE, ORLANDO, FL, 32806 |
| Rosenbaum Vic | Auth | 1414 KUHL AVE, ORLANDO, FL, 32806 |
| Nichols Cindy | Auth | 1414 KUHL AVE, ORLANDO, FL, 32806 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000129867 | SUMMERPORT SURGERY CENTER | ACTIVE | 2017-11-28 | 2027-12-31 | No data | 1414 KUHL AVE., MP2, ORLANDO, FL, 32806 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-02-08 | 5151 Winter Garden Vineland Rd., Suite 108, Windermere, FL 34786 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-23 | 5151 Winter Garden Vineland Rd., Suite 108, Windermere, FL 34786 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-16 | 207 W Gore St., Suite 201, ORLANDO, FL 32806 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-03-26 | Zika, Ryan | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-03-23 |
| ANNUAL REPORT | 2022-03-16 |
| AMENDED ANNUAL REPORT | 2021-12-21 |
| AMENDED ANNUAL REPORT | 2021-12-14 |
| ANNUAL REPORT | 2021-03-26 |
| ANNUAL REPORT | 2020-05-26 |
| ANNUAL REPORT | 2019-04-12 |
| ANNUAL REPORT | 2018-04-26 |
| Florida Limited Liability | 2017-11-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
