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OUTPATIENT SURGERY CENTER OF ST. AUGUSTINE, LLC - Florida Company Profile

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Company Details

Entity Name: OUTPATIENT SURGERY CENTER OF ST. AUGUSTINE, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active
Date Filed: 27 Dec 2004 (21 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 24 Aug 2023 (2 years ago)
Document Number: M05000000066
FEI/EIN Number 202047704
Address: 400 HEALTH PARK BLVD, ST. AUGUSTINE, FL, 32086, US
Mail Address: 400 HEALTH PARK BLVD, ST. AUGUSTINE, FL, 32086, US
ZIP code: 32086
City: Saint Augustine
County: St. Johns
Place of Formation: DELAWARE

Key Officers & Management

Name Role Address
Diaz Kimberly Manager 400 HEALTH PARK BLVD, ST. AUGUSTINE, FL, 32086
DeVooght Carlton Manager 400 HEALTH PARK BLVD, ST. AUGUSTINE, FL, 32086
Batenhorst Todd Dr. Manager 400 HEALTH PARK BLVD, ST. AUGUSTINE, FL, 32086
Cecil Melissa Manager 400 HEALTH PARK BLVD, ST. AUGUSTINE, FL, 32086
Cooper Jon Manager 400 HEALTH PARK BLVD, ST. AUGUSTINE, FL, 32086
Scott Carolyn Agent 100 Whetstone Place, St. Augustine, FL, 32086

National Provider Identifier

NPI Number:
1164491874

Authorized Person:

Name:
DR. ALBERT G. VOLK
Role:
PRESIDENT
Phone:

Taxonomy:

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

Contacts:

Fax:
9042091401

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-04-12 Scott, Carolyn -
REGISTERED AGENT ADDRESS CHANGED 2024-04-12 100 Whetstone Place, Suite 203, St. Augustine, FL 32086 -
LC STMNT OF RA/RO CHG 2023-08-24 - -
LC AMENDMENT 2017-12-07 - -
CHANGE OF PRINCIPAL ADDRESS 2017-12-07 400 HEALTH PARK BLVD, ST. AUGUSTINE, FL 32086 -
CHANGE OF MAILING ADDRESS 2017-12-07 400 HEALTH PARK BLVD, ST. AUGUSTINE, FL 32086 -

Documents

Name Date
ANNUAL REPORT 2024-04-12
CORLCRACHG 2023-08-24
ANNUAL REPORT 2023-03-10
ANNUAL REPORT 2022-04-26
ANNUAL REPORT 2021-03-01
ANNUAL REPORT 2020-04-02
ANNUAL REPORT 2019-01-28
AMENDED ANNUAL REPORT 2018-04-09
ANNUAL REPORT 2018-02-06
LC Amendment 2017-12-07

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Date of last update: 02 Jul 2025

Sources: Florida Department of State