| Entity Name: | PALM BEACH OUTPATIENT SURGERY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 22 Jul 2020 (5 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L20000207417 |
| FEI/EIN Number | 852173355 |
| Address: | 501 N Reo Street, tampa, FL, 33609, US |
| Mail Address: | 501 N Reo Street, tampa, FL, 33609, US |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962175059 | 2021-07-26 | 2021-07-26 | 504 N REO ST, TAMPA, FL, 336091013, US | 6910 S DIXIE HWY, WEST PALM BEACH, FL, 334054612, US | |||||||||||||
|
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| Phone | +1 813-549-2134 |
Authorized person
| Name | JOSHUA HELMS |
| Role | CHIEF OPERATING OFFICER |
| Phone | 8135492134 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Rajan-Wilson Rekha L | Agent | 504 N REO ST, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| WOOD DAVID A | Manager | 501 N REO ST, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| Priolo Mary | Vice President | 504 N REO STREET, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| Priolo Mary | o | 504 N REO STREET, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| Helms Josh | Chief Operating Officer | 504 N REO STREET, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| Gari Tracie | Chief Administrative Officer | 504 N. REO ST., TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| Wade Mark | Chief Executive Officer | 504 N REO ST, TAMPA, FL, 33609 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-08-15 | 501 N Reo Street, tampa, FL 33609 | No data |
| CHANGE OF MAILING ADDRESS | 2023-08-15 | 501 N Reo Street, tampa, FL 33609 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-03-12 | Rajan-Wilson, Rekha L | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-12 | 504 N REO ST, TAMPA, FL 33609 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-03-30 |
| ANNUAL REPORT | 2021-03-12 |
| Florida Limited Liability | 2020-07-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
