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TITUSVILLE CENTER FOR SURGICAL EXCELLENCE, LLC - Florida Company Profile

Company Details

Entity Name: TITUSVILLE CENTER FOR SURGICAL EXCELLENCE, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 18 May 2010 (15 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 28 Apr 2022 (3 years ago)
Document Number: M10000002243
FEI/EIN Number 263531997

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 14201 Dallas Parkway, Dallas, TX, 75254, US
Mail Address: 14201 Dallas Parkway, Dallas, TX, 75254, US
Place of Formation: DELAWARE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1831420694 2010-01-19 2024-09-10 814 S WASHINGTON AVE, TITUSVILLE, FL, 327802406, US 814 S WASHINGTON AVE, TITUSVILLE, FL, 327802406, US

Contacts

Phone +1 321-567-6300
Fax 3215676320

Authorized person

Name COLLIN LEMAISTRE
Role AUTHORIZED OFFICIAL
Phone 2142130732

Taxonomy

Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
License Number 1333
State FL
Is Primary Yes

Other Provider Identifiers

Issuer RAILROAD MEDICARE
Number P00934078
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TITUSVILLE CENTER FOR SURGICAL 401(K) PROFIT SHARING PLAN & TRUST 2011 263531997 2012-07-30 TITUSVILLE CENTER FOR SURGICAL EXCELLENCE LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621510
Sponsor’s telephone number 3215676300
Plan sponsor’s address 814 S. WASHINGTON AVE, TITUSVILLE, FL, 32780

Plan administrator’s name and address

Administrator’s EIN 263531997
Plan administrator’s name TITUSVILLE CENTER FOR SURGICAL EXCELLENCE LLC
Plan administrator’s address 15305 DALLAS PARKWAY, SUITE 1600, ADDISON, TX, 75001
Administrator’s telephone number 9727133539

Signature of

Role Plan administrator
Date 2012-07-30
Name of individual signing JOHN WELLIK
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
C T CORPORATION SYSTEM Agent -
TITAN HEALTH OF TITUSVILLE, INC. Manager -
Bowden James Secretary 14201 Dallas Parkway, Dallas, TX, 75254
LeMaistre Collin President 14201 Dallas Parkway, Dallas, TX, 75254
Edwards Beth Vice President 14201 Dallas Parkway, Dallas, TX, 75254
Sims Karen Auth 14201 Dallas Parkway, Dallas, TX, 75254

Events

Event Type Filed Date Value Description
REINSTATEMENT 2022-04-28 - -
REGISTERED AGENT NAME CHANGED 2022-04-28 C T CORPORATION SYSTEM -
REVOKED FOR ANNUAL REPORT 2021-09-24 - -
CHANGE OF PRINCIPAL ADDRESS 2020-06-20 14201 Dallas Parkway, Dallas, TX 75254 -
CHANGE OF MAILING ADDRESS 2020-06-20 14201 Dallas Parkway, Dallas, TX 75254 -

Documents

Name Date
ANNUAL REPORT 2024-05-02
ANNUAL REPORT 2023-04-18
REINSTATEMENT 2022-04-28
ANNUAL REPORT 2020-06-20
ANNUAL REPORT 2019-05-01
ANNUAL REPORT 2018-04-04
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-03-29
ANNUAL REPORT 2015-02-24
ANNUAL REPORT 2014-04-23

Date of last update: 01 Mar 2025

Sources: Florida Department of State