| Entity Name: | LAKEWOOD ASC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 27 Sep 2018 (6 years ago) |
| Document Number: | L18000230305 |
| FEI/EIN Number | 37-1912025 |
| Address: | 5571 E HWY 44, WILDWOOD, FL 34785 |
| Mail Address: | 5571 E HWY 44, WILDWOOD, FL 34785 |
| ZIP code: | 34785 |
| County: | Sumter |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821565706 | 2018-10-29 | 2020-10-21 | 5571 E SR 44 STE 501, WILDWOOD, FL, 347858282, US | 5571 E SR 44 STE 501, WILDWOOD, FL, 347858282, US | |||||||||||||||
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| Phone | +1 352-643-9080 |
| Fax | 3525716786 |
Authorized person
| Name | MR. JOSE A RIVERA |
| Role | ADMINISTRATOR |
| Phone | 3526439080 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAKEWOOD ASC LLC 401(K) PROFIT SHARING PLAN & TRUST | 2023 | 371912025 | 2024-05-03 | LAKEWOOD ASC LLC | 26 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 471637791 |
| Plan administrator’s name | ERISA FIDUCIARY SERVICES, INC. |
| Plan administrator’s address | 1373 VETERANS HIGHWAY, SUITE 10, HAUPPAUGE, NY, 11788 |
| Administrator’s telephone number | 6312490500 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-03 |
| Name of individual signing | ERISA FIDUCIARY SERVICES |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DELOACH, JERRALD | Agent | 308 W HIGHLAND BLVD, INVERNESS, FL 34452 |
| Name | Role | Address |
|---|---|---|
| ATTANTI, SRINIVAS | Authorized Member | 308 W HIGHLAND BLVD, INVERNESS, FL 34452 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-03-22 | DELOACH, JERRALD | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-22 |
| ANNUAL REPORT | 2023-04-16 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-03-23 |
| ANNUAL REPORT | 2020-05-29 |
| ANNUAL REPORT | 2019-04-01 |
| Florida Limited Liability | 2018-09-27 |
Date of last update: 17 Jan 2025
Sources: Florida Department of State
