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SUMMERLIN BEND SURGERY CENTER, L.L.C. - Florida Company Profile

Company Details

Entity Name: SUMMERLIN BEND SURGERY CENTER, L.L.C.
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

SUMMERLIN BEND SURGERY CENTER, L.L.C. is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 19 Nov 1999 (25 years ago)
Date of dissolution: 20 Dec 2000 (24 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 20 Dec 2000 (24 years ago)
Document Number: L99000007969
FEI/EIN Number 650963008

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 63 BARKLEY CIRCLE, S.W., SUITE 102, FORT MYERS, FL, 33907
Mail Address: 63 BARKLEY CIRCLE, S.W., SUITE 102, FORT MYERS, FL, 33907
ZIP code: 33907
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1770566192 2005-11-21 2012-06-25 5238 MASON CORBIN CT, STE 101, FT MYERS, FL, 339077738, US 5238 MASON CORBIN CT, STE 101, FT MYERS, FL, 339077738, US

Contacts

Phone +1 239-936-9700
Fax 2399369707

Authorized person

Name MS. LISA L KELLEY
Role ADMINISTRATOR
Phone 2399369700

Taxonomy

Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
State FL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 070785600
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SUMMERLIN BEND SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2023 651005912 2024-07-01 SUMMERLIN BEND SURGERY CENTER 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 2399369700
Plan sponsor’s address 5238 MASON CORBIN CT, SUITE 101, FORT MYERS, FL, 33907

Signature of

Role Plan administrator
Date 2024-07-01
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
SUMMERLIN BEND SURGERY CENTER, 401(K) PROFIT SHARING PLAN & TRUST 2022 651005912 2023-06-27 SUMMERLIN BEND SURGERY CENTER 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 2399369700
Plan sponsor’s address 5238 MASON CORBIN COURT, SUITE 101, FORT MYERS, FL, 33907

Signature of

Role Plan administrator
Date 2023-06-27
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
SUMMERLIN BEND SURGERY CENTER, 401(K) PROFIT SHARING PLAN & TRUST 2021 651005912 2022-08-05 SUMMERLIN BEND SURGERY CENTER 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 2399369700
Plan sponsor’s address 5238 MASON CORBIN COURT, SUITE 101, FORT MYERS, FL, 33907

Signature of

Role Plan administrator
Date 2022-08-05
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
SUMMERLIN BEND SURGERY CENTER, 401(K) PROFIT SHARING PLAN & TRUST 2020 651005912 2021-05-05 SUMMERLIN BEND SURGERY CENTER 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 2399369700
Plan sponsor’s address 5238 MASON CORBIN COURT, SUITE 101, FORT MYERS, FL, 33907

Signature of

Role Plan administrator
Date 2021-05-05
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
SUMMERLIN BEND SURGERY CENTER, 401(K) PROFIT SHARING PLAN & TRUST 2019 651005912 2020-06-10 SUMMERLIN BEND SURGERY CENTER 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 2399369700
Plan sponsor’s address 5238 MASON CORBIN COURT, SUITE 101, FORT MYERS, FL, 33907

Signature of

Role Plan administrator
Date 2020-06-10
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
SUMMERLIN BEND SURGERY CENTER, 401 K PROFIT SHARING PLAN TRUST 2018 651005912 2019-05-30 SUMMERLIN BEND SURGERY CENTER 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 2399369700
Plan sponsor’s address 5238 MASON CORBIN COURT, SUITE 101, FORT MYERS, FL, 33907

Plan administrator’s name and address

Administrator’s EIN 264477125
Plan administrator’s name 401K GENERATION
Plan administrator’s address 195 INTERNATIONAL PKWY, S #311, LAKE MARY, FL, 32746
Administrator’s telephone number 8669985879

Signature of

Role Plan administrator
Date 2019-05-30
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
SUMMERLIN BEND SURGERY CENTER, 401 K PROFIT SHARING PLAN TRUST 2017 651005912 2018-07-17 SUMMERLIN BEND SURGERY CENTER 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 2399369700
Plan sponsor’s address 5238 MASON CORBIN COURT, SUITE, FORT MYERS, FL, 33907

Signature of

Role Plan administrator
Date 2018-07-17
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
ANDREW DAVID S Manager 63 BARKLEY CIRCLE, S.W., SUITE 102, FORT MYERS, FL, 33907
CASTELLANO BRADLEY D Manager 63 BARKLEY CIRCLE, S.W., SUITE 102, FORT MYERS, FL, 33907
GOLDSTEIN JEROLD S Manager 63 BARKLEY CIRCLE, S.W., SUITE 102, FORT MYERS, FL, 33907
KLIMOWICN CHRIS D Manager 63 BARKLEY CIRCLE, S.W., SUITE 102, FORT MYERS, FL, 33907
IMANVEL HOWARD E Manager 63 BARKLEY CIRCLE, S.W., SUITE 102, FORT MYERS, FL, 33907
HOLBERG STEVEN E Manager 63 BARKLEY CIRCLE, S.W., SUITE 102, FORT MYERS, FL, 33907

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2000-12-20 - -
CHANGE OF PRINCIPAL ADDRESS 2000-01-24 63 BARKLEY CIRCLE, S.W., SUITE 102, FORT MYERS, FL 33907 -
CHANGE OF MAILING ADDRESS 2000-01-24 63 BARKLEY CIRCLE, S.W., SUITE 102, FORT MYERS, FL 33907 -

Documents

Name Date
Voluntary Dissolution 2000-12-20
Reg. Agent Resignation 2000-12-11
ANNUAL REPORT 2000-01-24
Florida Limited Liabilites 1999-11-19

Date of last update: 03 Apr 2025

Sources: Florida Department of State