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NORTHWEST FLORIDA SURGERY CENTER, LLC - Florida Company Profile

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Company Details

Entity Name: NORTHWEST FLORIDA SURGERY CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 29 Apr 2025 (4 months ago)
Document Number: L25000190781
Address: 767 AIRPORT ROAD, PANAMA CITY, FL, 32405, US
Mail Address: 767 AIRPORT ROAD, PANAMA CITY, FL, 32405, US
ZIP code: 32405
City: Panama City
County: Bay
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
BOYD GINGER ESQ Agent 215 S. MONROE ST, STE 400, TALLAHASSEE, FL, 32301
NFSC PHYSICIAN HOLDINGS, INC. Manager 767 AIRPORT ROAD, PANAMA CITY, FL, 32405

National Provider Identifier

NPI Number:
1992701049
Certification Date:
2025-05-29

Authorized Person:

Name:
MR. RON NMI SAMUELIAN
Role:
CEO
Phone:

Taxonomy:

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

Contacts:

Fax:
8509139744

Form 5500 Series

Employer Identification Number (EIN):
593123289
Plan Year:
2024
Number Of Participants:
66
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
70
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
69
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
67
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
69
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
CONVERSION 2025-04-29 - CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS A93000000719. CONVERSION NUMBER 100000267811

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Date of last update: 01 Aug 2025

Sources: Florida Department of State