| Entity Name: | ADVENTHEALTH SURGERY CENTER DAYTONA BEACH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 26 Aug 2021 (3 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 08 Mar 2023 (2 years ago) |
| Document Number: | L21000383379 |
| FEI/EIN Number | 92-2967648 |
| Address: | 103 Memorial Medical Pkwy, Daytona Beach, FL 32117 |
| Mail Address: | 103 Memorial Medical Pkwy, Daytona Beach, FL 32117 |
| ZIP code: | 32117 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386412344 | 2023-12-19 | 2024-07-15 | 103 MEMORIAL MEDICAL PARKWAY, SUITE 300, DAYTONA BEACH, FL, 32117, US | 103 MEMORIAL MEDICAL PARKWAY, SUITE 300, DAYTONA BEACH, FL, 32117, US | |||||||||||||
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| Phone | +1 386-231-8800 |
Authorized person
| Name | JOHN LAZARUS |
| Role | EXECUTIVE DIRECTOR AMBULATORY SERVI |
| Phone | 5865884440 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| CIK number | Mailing Address | Business Address | Phone | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1988751 | 03 MEMORIAL MEDICAL PARKWAY, DAYTONA BEACH, FL, 32117 | 03 MEMORIAL MEDICAL PARKWAY, DAYTONA BEACH, FL, 32117 | 386-917-7749 | |||||||||
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| Form type | D |
| File number | 021-498883 |
| Filing date | 2023-12-06 |
| File | View File |
| Name | Role | Address |
|---|---|---|
| Bromme, Jeff | Agent | 900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714-1502 |
| Name | Role | Address |
|---|---|---|
| Weis, David | Manager | 103 Memorial Medical Pkwy, Daytona Beach, FL 32117 |
| Morris, Shyroll | Manager | 103 Memorial Medical Pkwy, Daytona Beach, FL 32117 |
| Domayer, Cory | Manager | 103 Memorial Medical Parkway, Daytona Beach, FL 32117 |
| Thomas, Debora | Manager | 103 Memorial Medical Parkway, Daytona Beach, FL 32117 |
| Name | Role | Address |
|---|---|---|
| Thomas, Debora | Authorized Representative | 103 Memorial Medical Parkway, Daytona Beach, FL 32117 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000006123 | ADVENTHEALTH SURGERY CENTER DAYTONA BEACH | ACTIVE | 2024-01-10 | 2029-12-31 | No data | 103 MEMORIAL MEDICAL PKWY, DAYTONA BEACH,, FL, 32117 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC NAME CHANGE | 2023-03-08 | ADVENTHEALTH SURGERY CENTER DAYTONA BEACH, LLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-02 | 103 Memorial Medical Pkwy, Daytona Beach, FL 32117 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-02 | 103 Memorial Medical Pkwy, Daytona Beach, FL 32117 | No data |
| REINSTATEMENT | 2022-11-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-11-28 | Bromme, Jeff | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| LC Name Change | 2023-03-08 |
| AMENDED ANNUAL REPORT | 2023-02-28 |
| AMENDED ANNUAL REPORT | 2023-02-02 |
| ANNUAL REPORT | 2023-01-17 |
| AMENDED ANNUAL REPORT | 2022-12-09 |
| REINSTATEMENT | 2022-11-28 |
| Florida Limited Liability | 2021-08-26 |
Date of last update: 13 Jan 2025
Sources: Florida Department of State
