| Entity Name: | THE ENDOSCOPY GROUP, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Jul 1998 (27 years ago) |
| Document Number: | L98000000983 |
| FEI/EIN Number | 593519881 |
| Address: | 4810 NORTH DAVIS HIGHWAY, PENSACOLA, FL, 32503 |
| Mail Address: | 4810 NORTH DAVIS HIGHWAY, PENSACOLA, FL, 32503, US |
| ZIP code: | 32503 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003889346 | 2006-02-08 | 2018-03-01 | 4810 N DAVIS HWY, PENSACOLA, FL, 325032341, US | 4810 N DAVIS HWY, PENSACOLA, FL, 325032341, US | |||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 850-477-8109 |
| Fax | 8504789903 |
| Phone | +1 850-474-8988 |
Authorized person
| Name | MR. STEPHEN DUNN |
| Role | ADMINISTRATOR/CFO |
| Phone | 8504748988 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | 490003997 |
| Issuer | AETNA |
| Number | 5121097 |
| Issuer | CIGNA |
| Number | 3804534 |
| Issuer | USA HEALTH NETWORK |
| Number | 987585 |
| Issuer | MEDICAID |
| Number | 079204700 |
| State | FL |
| Issuer | HEALTH OPTIONS |
| Number | 65B |
| Name | Role | Address |
|---|---|---|
| Dunn Steve | Agent | 4810 NORTH DAVIS HIGHWAY, PENSACOLA, FL, 32503 |
| Name | Role | Address |
|---|---|---|
| Condon Willis F | Manager | 5151 NORTH 9TH AVENUE, PENSACOLA, FL, 32504 |
| Stringfellow Drew | Manager | 5151 N 9TH AVE, PENSACOLA, FL, 32504 |
| Hakim Fares | Manager | 4810 N Davis Hwy, PENSACOLA, FL, 32503 |
| Speer Carl | Manager | 4810 N Davis Hwy, Penacola, FL, 32503 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G04092900022 | THE ENDOSCOPY CENTER OF PENSACOLA | EXPIRED | 2004-04-01 | 2024-12-31 | No data | 4810 NORTH DAVIS HIGHWAY, PENSACOLA, FL, 32503 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2005-04-20 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
