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ORANGE AVENUE SURGERY CENTER, LLC - Florida Company Profile

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Company Details

Entity Name: ORANGE AVENUE SURGERY CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 20 Oct 2021 (4 years ago)
Document Number: L21000457336
FEI/EIN Number 87-3257002
Mail Address: 102 W. Pineloch Ave., Suite 23, ORLANDO, FL, 32806, US
Address: 1405 S. Orange Avenue, Suite 120, ORLANDO, FL, 32806, US
ZIP code: 32806
City: Orlando
County: Orange
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Heeter Colleen Auth 1414 KUHL AVE., MP 2, ORLANDO, FL, 32806
OHE GREG Auth 1414 KUHL AVE., MP 2, ORLANDO, FL, 32806
Nichols Cynthia Auth 1414 KUHL AVE., MP2, ORLANDO, FL, 32806
ZIKA RYAN Agent 207 W. Gore St., Suite 201, ORLANDO, FL, 32806
- Manager -

National Provider Identifier

NPI Number:
1790442895
Certification Date:
2021-11-24

Authorized Person:

Name:
MISS JAN DIEDRICH
Role:
VICE PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000162024 ORANGE AVENUE SURGERY CENTER ACTIVE 2021-12-07 2026-12-31 - 1414 KUHL AVE., MP 2, ORLANDO, FL, 32806

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2024-02-08 1405 S. Orange Avenue, Suite 120, ORLANDO, FL 32806 -
CHANGE OF PRINCIPAL ADDRESS 2022-04-27 1405 S. Orange Avenue, Suite 120, ORLANDO, FL 32806 -
REGISTERED AGENT ADDRESS CHANGED 2022-03-16 207 W. Gore St., Suite 201, ORLANDO, FL 32806 -

Documents

Name Date
ANNUAL REPORT 2024-02-08
ANNUAL REPORT 2023-04-06
AMENDED ANNUAL REPORT 2022-04-27
ANNUAL REPORT 2022-03-16
Florida Limited Liability 2021-10-20

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Date of last update: 02 Jul 2025

Sources: Florida Department of State