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PUTNAM AMBULATORY SURGERY CENTER, LLC - Florida Company Profile

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Company Details

Entity Name: PUTNAM AMBULATORY SURGERY CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Inactive
Date Filed: 05 Jan 2005 (21 years ago)
Date of dissolution: 01 May 2015 (10 years ago)
Last Event: LC WITHDRAWAL
Event Date Filed: 01 May 2015 (10 years ago)
Document Number: M05000000077
FEI/EIN Number 202082396
Address: 330 Seven Springs Way, Brentwood, TN, 37027, US
Mail Address: 330 Seven Springs Way, Brentwood, TN, 37027, US
Place of Formation: DELAWARE

Key Officers & Management

Name Role Address
- Agent -
Bivacca Donald J Manager 330 Seven Springs Way, Brentwood, TN, 37027
Frantz Steve W Manager 330 Seven Springs Way, Brentwood, TN, 37027
Teague Kathy Manager 330 Seven Springs Way, Brentwood, TN, 37027
Coggin Michael S Manager 330 Seven Springs Way, Brentwood, TN, 37027
Green Christy S Manager 330 Seven Springs Way, Brentwood, TN, 37027
Monte Christopher J Manager 330 Seven Springs Way, Brentwood, TN, 37027

National Provider Identifier

NPI Number:
1780771923

Authorized Person:

Name:
WILLIAM M. GRACEY
Role:
COO
Phone:

Taxonomy:

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

Contacts:

Fax:
6153728572
Fax:
3863258178

Events

Event Type Filed Date Value Description
LC WITHDRAWAL 2015-05-01 - -
CHANGE OF PRINCIPAL ADDRESS 2014-05-01 330 Seven Springs Way, Brentwood, TN 37027 -
CHANGE OF MAILING ADDRESS 2014-05-01 330 Seven Springs Way, Brentwood, TN 37027 -

Documents

Name Date
LC Withdrawal 2015-05-01
ANNUAL REPORT 2015-04-11
ANNUAL REPORT 2014-05-01
ANNUAL REPORT 2013-01-30
ANNUAL REPORT 2012-01-05
ANNUAL REPORT 2011-01-13
ANNUAL REPORT 2010-04-06
ANNUAL REPORT 2009-03-18
ANNUAL REPORT 2008-04-30
ANNUAL REPORT 2007-04-18

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Date of last update: 02 Aug 2025

Sources: Florida Department of State