| Entity Name: | EAST WEST LASER AND AMBULATORY SURGERY CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 15 Jun 2021 (4 years ago) |
| Document Number: | L21000278684 |
| FEI/EIN Number | 87-1385278 |
| Address: | 1855 EAST-WEST PARKWAY, SUITE 1, FLEMING ISLAND, FL, 32003 |
| Mail Address: | 1855 EAST-WEST PARKWAY, SUITE 1, FLEMING ISLAND, FL, 32003 |
| ZIP code: | 32003 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225701824 | 2021-07-29 | 2021-07-29 | 1855 EAST-WEST PARKWAY, SUITE 1, FLEMING ISLAND, FL, 32003, US | 1855 EAST-WEST PARKWAY, SUITE 1, FLEMING ISLAND, FL, 32003, US | |||||||||||||||
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| Phone | +1 561-630-6277 |
| Fax | 5616306062 |
Authorized person
| Name | DR. RUSSELL A. PECORARO |
| Role | MANAGER |
| Phone | 9042722020 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KING ERIC J | Agent | 1855 EAST-WEST PARKWAY, FLEMING ISLAND, FL, 32003 |
| Name | Role | Address |
|---|---|---|
| DOWNER DONALD M | Manager | 1855 EAST-WEST PARKWAY, FLEMING ISLAND, FL, 32003 |
| PECORARO RUSSELL A | Manager | 1855 EAST-WEST PARKWAY, FLEMING ISLAND, FL, 32003 |
| LEVINE LAWRENCE M | Manager | 1855 EAST-WEST PARKWAY, FLEMING ISLAND, FL, 32003 |
| HAYES DAVID W | Manager | 1855 EAST-WEST PARKWAY, FLEMING ISLAND, FL, 32003 |
| DuPree Jameson P | Manager | 1855 EAST-WEST PARKWAY, FLEMING ISLAND, FL, 32003 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000016685 | EAST WEST SURGERY CENTER | ACTIVE | 2022-02-09 | 2027-12-31 | No data | 1855 EAST-WEST PARKWAY, SUITE 1, FLEMING ISLAND, FL, 32003 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-01-28 |
| Florida Limited Liability | 2021-06-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
