SURGERY CENTER OF SOUTHWEST FLORIDA, INC. - Florida Company Profile

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Company Details

Entity Name:	SURGERY CENTER OF SOUTHWEST FLORIDA, INC.
Jurisdiction:	FLORIDA
Filing Type:	Domestic Profit
Status:	Inactive
Date Filed:	16 Jun 2000 (25 years ago)
Date of dissolution:	25 Sep 2020 (5 years ago)
Last Event:	ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed:	25 Sep 2020 (5 years ago)
Document Number:	P00000058660
FEI/EIN Number	651022543
Address:	12631 WHITEHALL DRIVE, FORT MYERS, FL, 33907
Mail Address:	507 DEL PRADO BLVD. S, CAPE CORAL, FL, 33990
ZIP code:	33907
City:	Fort Myers
County:	Lee
Place of Formation:	FLORIDA

Key Officers & Management

Name	Role	Address
EVANS WILLIAM P	President	5598 SUNDOWN HARBOUR COURT, FORT MYERS, FL, 33919
BORDEN JAMES D	Vice President	3880 W RIVERSIDE DRIVE, FORT MYERS, FL, 33901
RIZZO JASPER J	Officer	14169 REFLECTION LAKES DR, FORT MYERS, FL, 33907
STRICKLAND MICHAEL G	Officer	6680 DANIEL CT, FORT MYERS, FL, 33908
Evans Blake P	Officer	1221 CANTERBURY DR, FORT MYERS, FL, 33901
BRETTON PAUL R	Director	4849 LAUREL LANE, FORT MYERS, FL, 33908
EVANS WILLIAM P	Agent	12631 WHITEHALL DRIVE, FORT MYERS, FL, 33907

National Provider Identifier

NPI Number:

1689624793

Link:

View on NPI website

Authorized Person:

Name:

DR. PAUL R BRETTON

Role:

MEDICAL DIRECTOR

Phone:

2399394758

Taxonomy:

Selected Taxonomy:

261QA1903X - Ambulatory Surgical Clinic/Center

Is Primary:

Yes

Contacts:

Phone:

+1 239-939-4758

Fax:

2394797874

Form 5500 Series

Employer Identification Number (EIN):

651022543

Plan Year:

2020

Number Of Participants:

Sponsors Telephone Number:

2393377874

File:

View File