| Entity Name: | MIAMI KENDALL FL ENDOSCOPY ASC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Jun 2008 (17 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 17 May 2017 (8 years ago) |
| Document Number: | M08000002942 |
| FEI/EIN Number | 262841769 |
| Address: | 1A BURTON HILLS BLVD, SUITE 300, NASHVILLE, TN, 37215, US |
| Mail Address: | 1A BURTON HILLS BLVD, SUITE 300, NASHVILLE, TN, 37215, US |
| Place of Formation: | TENNESSEE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548414816 | 2008-11-12 | 2023-09-07 | 7600 SW 87TH AVE, MIAMI, FL, 331733505, US | 7600 SW 87TH AVE, MIAMI, FL, 331733505, US | |||||||||||||||||||||
|
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| Phone | +1 615-665-1283 |
| Fax | 6156650755 |
Authorized person
| Name | MR. PHILLIP A. CLENDENIN |
| Role | PRESIDENT |
| Phone | 6156651283 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003044100 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| Reber Paige | Secretary | 1A BURTON HILLS BLVD, NASHVILLE, TN, 37215 |
| Name | Role |
|---|---|
| AMSURG HOLDINGS, LLC | Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08259900002 | GALLOWAY SURGERY CENTER | EXPIRED | 2008-09-15 | 2013-12-31 | No data | 20 BURTON HILLS BLVD., 5TH FLOOR, NASHVILLE, TN, 37215 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-23 | 1A BURTON HILLS BLVD, SUITE 300, NASHVILLE, TN 37215 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-23 | 1A BURTON HILLS BLVD, SUITE 300, NASHVILLE, TN 37215 | No data |
| LC STMNT OF RA/RO CHG | 2017-05-17 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-05-17 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-05-17 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-25 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-24 |
| CORLCRACHG | 2017-05-17 |
| ANNUAL REPORT | 2017-04-20 |
| ANNUAL REPORT | 2016-03-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
