| Entity Name: | CVI AMBULATORY SURGERY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Feb 2020 (5 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 17 Apr 2023 (2 years ago) |
| Document Number: | L20000042717 |
| FEI/EIN Number | 84-4815499 |
| Address: | 2111 SW 20TH PLACE, OCALA, FL, 34471, US |
| Mail Address: | 2111 SW 20TH PLACE, OCALA, FL, 34471, US |
| ZIP code: | 34471 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942884457 | 2021-05-11 | 2021-05-11 | 2111 SW 20TH PL, OCALA, FL, 344717734, US | 6547 SW STATE ROAD 200, OCALA, FL, 344765575, US | |||||||||||||
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| Phone | +1 352-622-4251 |
Authorized person
| Name | RANDY WARDLOW |
| Role | ADMINISTRATOR |
| Phone | 3526224251 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 S PINE ISLAND RD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| GUMMADI SIVA M.D. | Manager | 2111 SW 20TH PLACE, OCALA, FL, 34471 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000013147 | SURGERY CENTER OF CENTRAL FLORIDA | ACTIVE | 2023-01-27 | 2028-12-31 | No data | 6547 SW STATE ROAD 200, OCALA, FL, 34476 |
| G21000037675 | SURGERY CENTER OF CENTRAL FLORIDA | ACTIVE | 2021-03-18 | 2026-12-31 | No data | 2111 SW 20TH PLACE, OCALA, FL, 34471 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2023-04-17 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-17 | CT CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-17 | 1200 S PINE ISLAND RD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-04-28 |
| CORLCRACHG | 2023-04-17 |
| ANNUAL REPORT | 2022-04-01 |
| ANNUAL REPORT | 2021-04-07 |
| Florida Limited Liability | 2020-02-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
