| Entity Name: | TGH SURGERY CENTER AT MORSANI, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 Jun 2021 (4 years ago) |
| Document Number: | L21000273737 |
| FEI/EIN Number | 87-1193981 |
| Address: | 13330 USF LAUREL DRIVE, MDH 2ND FLOOR, TAMPA, FL 33601 |
| Mail Address: | 13330 USF LAUREL DRIVE, MDH 2ND FLOOR, TAMPA, FL 33612 |
| ZIP code: | 33601 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679602544 | 2007-03-05 | 2021-10-22 | 12901 BRUCE B DOWNS BLVD # 52, TAMPA, FL, 336124742, US | 13330 USF LAUREL DR FL DRIVE2, TAMPA, FL, 336126601, US | |||||||||||||||||||
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| Phone | +1 813-396-2376 |
| Fax | 8133962351 |
Authorized person
| Name | ADAM SMITH |
| Role | PRESIDENT |
| Phone | 8138443116 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 1302 |
| State | FL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CF REGISTERED AGENT, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| SMITH, ADAM | President | PO BOX 1289, TAMPA, FL 33601-1289 |
| Name | Role | Address |
|---|---|---|
| SMITH, ADAM | Director | PO BOX 1289, TAMPA, FL 33601-1289 |
| DAWKINS, MARION | Director | PO BOX 1289, TAMPA, FL 33601-1289 |
| LOKENAUTH, LIJAH | Director | PO BOX 1289, TAMPA, FL 33601-1289 |
| DUBAULT, RENEE | Director | 13330 USF LAUREL DRIVE, MDH 2ND FLOOR TAMPA, FL 33612 |
| TAUNK, PUSHPAK, MD | Director | 13330 USF LAUREL DRIVE, MDH 2ND FLOOR TAMPA, FL 33612 |
| Name | Role | Address |
|---|---|---|
| DAWKINS, MARION | Vice President | PO BOX 1289, TAMPA, FL 33601-1289 |
| Name | Role | Address |
|---|---|---|
| DAWKINS, MARION | Secretary | PO BOX 1289, TAMPA, FL 33601-1289 |
| Name | Role | Address |
|---|---|---|
| LOKENAUTH, LIJAH | Treasurer | PO BOX 1289, TAMPA, FL 33601-1289 |
| Name | Role | Address |
|---|---|---|
| JARSTAD, JOHN, MD | MEDICAL DIRECTOR | 13330 USF LAUREL DRIVE, MDH 2ND FLOOR TAMPA, FL 33612 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000102605 | TGH SURGERY CENTER | ACTIVE | 2021-08-06 | 2026-12-31 | No data | 13330 USF LAUREL DRIVE, MDH 2ND FLOOR, TAMPA, FL, 33612 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-11-10 | 13330 USF LAUREL DRIVE, MDH 2ND FLOOR, TAMPA, FL 33601 | No data |
| CHANGE OF MAILING ADDRESS | 2021-11-10 | 13330 USF LAUREL DRIVE, MDH 2ND FLOOR, TAMPA, FL 33601 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-04-30 |
| Florida Limited Liability | 2021-06-11 |
Date of last update: 14 Jan 2025
Sources: Florida Department of State
