| Entity Name: | SUNRISE OPHTHALMOLOGY ASC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| 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: | 22 Mar 2001 (24 years ago) |
| Date of dissolution: | 25 Sep 2015 (10 years ago) |
| Last Event: | REVOKED FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (10 years ago) |
| Document Number: | M01000000628 |
| FEI/EIN Number |
621848874
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 7805 SW 6 COURT, PLANTATION, FL, 33324 |
| Mail Address: | 7805 SW 6 COURT, PLANTATION, FL, 33324 |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | TENNESSEE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215900246 | 2006-02-09 | 2009-05-06 | 3737 N PINE ISLAND RD, SUNRISE, FL, 333516528, US | 3737 N PINE ISLAND RD, SUNRISE, FL, 333516528, US | |||||||||||||||||||||||||
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| Phone | +1 954-572-5888 |
| Fax | 9545725994 |
Authorized person
| Name | MS. BILLIE A PAYNE |
| Role | PRESIDENT |
| Phone | 6156651283 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 750 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 075162600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WEINBERG STEVEN AESQ. | Agent | FRANK, WEINBERG & BLACK, P.L., PLANTATION, FL, 33324 |
| PHYSICIAN HOLDING CORP. | Managing Member | - |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REVOKED FOR ANNUAL REPORT | 2015-09-25 | - | - |
| LC DISSOCIATION MEM | 2014-07-16 | - | - |
| LC STMNT OF RA/RO CHG | 2014-06-09 | - | - |
| REGISTERED AGENT NAME CHANGED | 2014-06-09 | WEINBERG, STEVEN A, ESQ. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2014-06-09 | FRANK, WEINBERG & BLACK, P.L., 7805 SW 6 COURT, PLANTATION, FL 33324 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2014-06-09 | 7805 SW 6 COURT, PLANTATION, FL 33324 | - |
| CHANGE OF MAILING ADDRESS | 2014-06-09 | 7805 SW 6 COURT, PLANTATION, FL 33324 | - |
| LC NAME CHANGE | 2014-01-17 | SUNRISE OPHTHALMOLOGY ASC, LLC | - |
| NAME CHANGE AMENDMENT | 2001-10-26 | THE SUNRISE OPHTHALMOLOGY ASC, LLC | - |
| Name | Date |
|---|---|
| CORLCDSMEM | 2014-07-16 |
| CORLCRACHG | 2014-06-09 |
| ANNUAL REPORT | 2014-03-25 |
| LC Name Change | 2014-01-17 |
| ANNUAL REPORT | 2013-04-16 |
| ANNUAL REPORT | 2012-04-12 |
| ANNUAL REPORT | 2011-02-15 |
| ANNUAL REPORT | 2010-02-18 |
| ANNUAL REPORT | 2009-04-09 |
| ANNUAL REPORT | 2008-05-02 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
