| Entity Name: | OBSIDIAN SURGICAL SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 May 2021 (4 years ago) |
| Document Number: | L21000212389 |
| FEI/EIN Number | 86-3996907 |
| Address: | 3319 MARBLE CREST DR, LAND O LAKES, FL, 34638, US |
| Mail Address: | 3319 MARBLE CREST DR, LAND O LAKES, FL, 34638, US |
| ZIP code: | 34638 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003485541 | 2021-06-19 | 2021-06-19 | 3319 MARBLE CREST DR, LAND O LAKES, FL, 346386082, US | 3319 MARBLE CREST DR, LAND O LAKES, FL, 346386082, US | |||||||||||||||||||||
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| Phone | +1 352-514-3413 |
Authorized person
| Name | ASHLEE R MCNIFF |
| Role | CEO |
| Phone | 3525143413 |
Taxonomy
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363AM0700X - Medical Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363AS0400X - Surgical Physician Assistant |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MCNIFF ASHLEE R | Agent | 3319 MARBLE CREST DR, LAND O LAKES, FL, 34638 |
| Name | Role | Address |
|---|---|---|
| MCNIFF ASHLEE R | Manager | 3319 MARBLE CREST DR, LAND O LAKES, FL, 34638 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-03-08 |
| ANNUAL REPORT | 2022-03-18 |
| Florida Limited Liability | 2021-05-06 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
