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ADVENTHEALTH POLK SOUTH, INC. - Florida Company Profile

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Company Details

Entity Name: ADVENTHEALTH POLK SOUTH, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
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: 15 Apr 2019 (6 years ago)
Document Number: N19000003976
FEI/EIN Number 834672945

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

Address: 900 HOPE WAY, ALTAMONTE SPRINGS, FL, 32714, US
Mail Address: 900 HOPE WAY, ALTAMONTE SPRINGS, FL, 32714, US
ZIP code: 32714
County: Seminole
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Foltz Robert C Assi 26300 Siena Dr., Bonita Springs, FL, 34134
Saunders Mike Assi 900 Hope Way, Altamonte Springs, FL, 32714
Harcombe Doug Director 900 HOPE WAY, ALTAMONTE SPRINGS, FL, 32714
Hilliard Doug Director 601 E Rollins St, Orlando, FL, 32803
Addiscott Lynn Assi 900 Hope Way, Altamonte Springs, FL, 32714
Schuman Jessica S Agent 14055 Riveredge Drive, Suite 250, Tampa, FL, 33637
Graff Jeff Assi 900 Hope Way, Altamonte Springs, FL, 32714

National Provider Identifier

NPI Number:
1033770284
Certification Date:
2022-05-18

Authorized Person:

Name:
ALAN JUSTIN HENGESBACH
Role:
CFO
Phone:

Taxonomy:

Selected Taxonomy:
273R00000X - Psychiatric Hospital Unit
Is Primary:
Yes

Contacts:

Fax:
8632971867

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000042945 ADVENTHEALTH IMAGING LAKE WALES ACTIVE 2023-04-04 2028-12-31 - 410 SOUTH 11TH STREET, LAKE WALES, FL, 33853
G23000017364 ADVENTHEALTH WOUND CARE CENTER LAKE WALES ACTIVE 2023-02-06 2028-12-31 - 451 SOUTH 11TH STREET, LAKE WALES, FL, 33853
G23000016870 ADVENTHEALTH WEST FLORIDA DIVISION ACTIVE 2023-02-03 2028-12-31 - 14055 RIVEREDGE DR, SUITE 250, TAMPA, FL, 33637
G19000072327 ADVENTHEALTH SPORTS MED & REHAB LAKE WALES ACTIVE 2019-06-28 2029-12-31 - 425 SOUTH 11TH STREET, LAKE WALES, FL, 33853
G19000072320 ADVENTHEALTH LAB ACTIVE 2019-06-28 2029-12-31 - 410 SOUTH 11TH STREET, LAKE WALES, FL, 33853
G19000072321 ADVENTHEALTH WOUND CARE LAKE WALES EXPIRED 2019-06-28 2024-12-31 - 451 SOUTH 11TH STREET, LAKE WALES, FL, 33853
G19000067921 ADVENTHEALTH LAKE WALES ACTIVE 2019-06-14 2029-12-31 - 410 S. 11TH STREET, LAKE WALES, FL, 33853-4203

Events

Event Type Filed Date Value Description
AMENDMENT 2025-04-23 - -
REGISTERED AGENT NAME CHANGED 2022-09-09 Schuman, Jessica S -
REGISTERED AGENT ADDRESS CHANGED 2022-09-09 14055 Riveredge Drive, Suite 250, Tampa, FL 33637 -

Documents

Name Date
ANNUAL REPORT 2025-01-02
ANNUAL REPORT 2024-04-23
ANNUAL REPORT 2023-01-17
AMENDED ANNUAL REPORT 2022-09-09
AMENDED ANNUAL REPORT 2022-05-03
ANNUAL REPORT 2022-04-21
ANNUAL REPORT 2021-04-21
Reg. Agent Change 2020-12-11
ANNUAL REPORT 2020-06-23
Domestic Non-Profit 2019-04-15

Tax Exempt

Employer Identification Number (EIN) :
83-4672945
In Care Of Name:
% TAMARA L TRIMBLE
Classification:
Religious Organization
Ruling Date:
1950-01

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Date of last update: 02 Jun 2025

Sources: Florida Department of State