| Entity Name: | CORAL SPRINGS AMBULATORY SURGERY CENTER, 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: | 27 Jan 1999 (26 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 17 May 2017 (8 years ago) |
| Document Number: | M99000000113 |
| FEI/EIN Number |
650878926
Federal Employer Identification (FEI) Number assigned by the IRS. |
| 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: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114976651 | 2006-05-10 | 2023-09-07 | 1725 UNIVERSITY DRIVE, 2ND FLOOR, CORAL SPRINGS, FL, 33071, US | 1725 UNIVERSITY DRIVE, 2ND FLOOR, CORAL SPRINGS, FL, 33071, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-227-7760 |
| Fax | 9542279975 |
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 | VISTA |
| Number | SG013546 |
| Issuer | AETNA |
| Number | 2167675 |
| State | FL |
| Issuer | BC |
| Number | 63K |
| State | FL |
| Issuer | MEDICAID |
| Number | 070313300 |
| State | FL |
| Issuer | AVMED |
| Number | 261016 |
| Issuer | NEIGHBORHOOD |
| Number | 30734 |
| Issuer | AMERIGROUP |
| Number | 215430 |
| Name | Role | Address |
|---|---|---|
| CORAL SPRINGS NSC, LLC | Member | - |
| Reber Paige | Secretary | 1A BURTON HILLS BLVD., NASHVILLE, TN, 37215 |
| CORPORATION SERVICE COMPANY | Agent | - |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-23 | 1A BURTON HILLS BLVD., Suite 300, NASHVILLE, TN 37215 | - |
| CHANGE OF MAILING ADDRESS | 2024-04-23 | 1A BURTON HILLS BLVD., Suite 300, NASHVILLE, TN 37215 | - |
| LC STMNT OF RA/RO CHG | 2017-05-17 | - | - |
| REGISTERED AGENT NAME CHANGED | 2017-05-17 | CORPORATION SERVICE COMPANY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2017-05-17 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-04-15 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-22 |
| ANNUAL REPORT | 2019-04-17 |
| ANNUAL REPORT | 2018-04-20 |
| CORLCRACHG | 2017-05-17 |
| ANNUAL REPORT | 2017-04-20 |
| ANNUAL REPORT | 2016-03-30 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
