| Entity Name: | BIG BEND OPERATIONS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 17 Apr 1997 (28 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P97000035234 |
| FEI/EIN Number | 59-3456480 |
| Address: | 555 N. BYRON BUTLER PARKWAY, PERRY, FL 32347 |
| Mail Address: | 1414 COUNTY HIGHWAY 283 SOUTH, SUITE B, SANTA ROSA BEACH, FL 32459 |
| ZIP code: | 32347 |
| County: | Taylor |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699770545 | 2005-06-16 | 2009-02-19 | 555 N BYRON BUTLER PKWY, PERRY, FL, 323472315, US | 555 N BYRON BUTLER PKWY, PERRY, FL, 323472315, US | |||||||||||||||||||||||||||||
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| Phone | +1 850-584-2778 |
| Fax | 8505842790 |
Authorized person
| Name | CHARLES SCOTT KEELER |
| Role | MANAGER EMPLOYEE / CEO |
| Phone | 8505842778 |
Taxonomy
| Taxonomy Code | 156FX1800X - Optician |
| Is Primary | No |
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 1076 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 079243800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHIPMAN, GARY AESQ | Agent | 1414 COUNTY HIGHWAY 283 SOUTH, SUITE B, SANTA ROSA BEACH, FL 32459 |
| Name | Role | Address |
|---|---|---|
| SHIPMAN, GARY A | President | 1414 COUNTY HIGHWAY 283 SOUTH, SUITE B, SANTA ROSA BEACH, FL 32459 |
| Name | Role | Address |
|---|---|---|
| SHUGAR, DANIEL | Vice President | 150 TEHAMA COURT, SAN BRUNO, CA 94066 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09000158701 | NATURE COAST REGIONAL SURGERY CENTER | EXPIRED | 2009-09-24 | 2014-12-31 | No data | 555 N BYRON BUTLER PKWY, PERRY, FL, 32347 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2009-02-26 | 555 N. BYRON BUTLER PARKWAY, PERRY, FL 32347 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-02-26 | 1414 COUNTY HIGHWAY 283 SOUTH, SUITE B, SANTA ROSA BEACH, FL 32459 | No data |
| AMENDMENT | 2008-09-08 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2001-03-23 | 555 N. BYRON BUTLER PARKWAY, PERRY, FL 32347 | No data |
| REGISTERED AGENT NAME CHANGED | 2001-03-23 | SHIPMAN, GARY AESQ | No data |
| REINSTATEMENT | 1999-05-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1998-10-16 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-03-16 |
| ANNUAL REPORT | 2009-02-26 |
| Amendment | 2008-09-08 |
| ANNUAL REPORT | 2008-04-29 |
| ANNUAL REPORT | 2007-01-26 |
| ANNUAL REPORT | 2006-04-28 |
| ANNUAL REPORT | 2005-04-28 |
| ANNUAL REPORT | 2004-03-08 |
| ANNUAL REPORT | 2003-01-23 |
| ANNUAL REPORT | 2002-05-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
