| Entity Name: | THE MOUNT DORA OPHTHALMOLOGY ASC, 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: | 30 Sep 1999 (25 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 17 May 2017 (8 years ago) |
| Document Number: | M99000001538 |
| FEI/EIN Number |
621795778
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1A BURTON HILLS BOULEVARD, SUITE 300, NASHVILLE, TN, 37215, US |
| Mail Address: | 1A BURTON HILLS BOULEVARD, SUITE 300, NASHVILLE, TN, 37215, US |
| Place of Formation: | TENNESSEE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497728984 | 2006-02-07 | 2022-10-31 | 1A BURTON HILLS BLVD # L&C, NASHVILLE, TN, 372156187, US | 17564 US HIGHWAY 441, MOUNT DORA, FL, 327576711, US | |||||||||||||||||||||||||||||
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| Phone | +1 615-240-3820 |
| Fax | 6152341720 |
| Phone | +1 352-735-4100 |
| Fax | 3527352444 |
Authorized person
| Name | MR. JEFFREY SNODGRASS |
| Role | PRESIDENT |
| Phone | 6156651283 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 876 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 079101600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Reber Paige | Secretary | 1A BURTON HILLS BOULEVARD, NASHVILLE, TN, 37215 |
| AMSURG HOLDINGS, LLC | Member | - |
| CORPORATION SERVICE COMPANY | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G99277900077 | MID-FLORIDA SURGERY CENTER | ACTIVE | 1999-10-04 | 2029-12-31 | - | 1A BURTON HILLS BLVD, STE 300, NASVILLE, TN, 37215 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-23 | 1A BURTON HILLS BOULEVARD, SUITE 300, NASHVILLE, TN 37215 | - |
| CHANGE OF MAILING ADDRESS | 2024-04-23 | 1A BURTON HILLS BOULEVARD, 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 | 2023-04-24 |
| 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: 03 Mar 2025
Sources: Florida Department of State
