| Entity Name: | THE CAPE CORAL FL ENDOSCOPY 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: | 15 Aug 2005 (20 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | REVOKED FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | M05000004522 |
| FEI/EIN Number |
203277058
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 20 BURTON HILLS BLVD., 5TH FLOOR, NASHVILLE, TN, 37215 |
| Mail Address: | 20 BURTON HILLS BLVD., 5TH FLOOR, NASHVILLE, TN, 37215 |
| Place of Formation: | TENNESSEE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457310831 | 2006-03-22 | 2009-05-15 | 665 DEL PRADO BLVD, CAPE CORAL, FL, 339905630, US | 665 DEL PRADO BLVD, CAPE CORAL, FL, 339905630, US | |||||||||||||||||||||||||||||||
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| Phone | +1 239-772-8892 |
| Fax | 2395746262 |
Authorized person
| Name | MS. BILLIE A PAYNE |
| Role | PRESIDENT |
| Phone | 6156651283 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 910 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 076178800 |
| State | FL |
| Issuer | HUMANA MILITARY-TRICARE |
| Number | 621767599 |
| State | FL |
| Name | Role |
|---|---|
| AMSURG HOLDINGS, INC. | Managing Member |
| CAPE CORAL GI PHYSICIANS, LLC | Managing Member |
| NRAI SERVICES, INC. | Agent |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000014865 | LIFELINE ENDOSCOPY CENTER | EXPIRED | 2011-02-08 | 2016-12-31 | - | 20 BURTON HILLS BLVD., SUITE 500, NASHVILLE, TN, 37215 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REVOKED FOR ANNUAL REPORT | 2012-09-28 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2011-02-11 | 1200 South Pine Island Road, Plantation, FL 33324 | - |
| REGISTERED AGENT NAME CHANGED | 2006-12-26 | NRAI SERVICES, INC | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13000494642 | TERMINATED | 1000000434770 | LEE | 2013-01-31 | 2023-02-27 | $ 1,264.78 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1401 W US HIGHWAY 90 STE 100, LAKE CITY FL320556123 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-02-15 |
| ANNUAL REPORT | 2010-02-18 |
| ANNUAL REPORT | 2009-04-09 |
| ANNUAL REPORT | 2008-05-02 |
| ANNUAL REPORT | 2007-05-04 |
| Reg. Agent Change | 2006-12-26 |
| ANNUAL REPORT | 2006-05-11 |
| Foreign Limited | 2005-08-15 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
