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  5. NORTHWEST FLORIDA SURGERY CENTER, INC.

NORTHWEST FLORIDA SURGERY CENTER, INC. - Florida Company Profile

Company Details

Entity Name: NORTHWEST FLORIDA SURGERY CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

NORTHWEST FLORIDA SURGERY CENTER, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
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: 08 Sep 1992 (33 years ago)
Document Number: V63202
FEI/EIN Number 593123289

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 767 AIRPORT ROAD, PANAMA CITY, FL, 32405, US
Mail Address: 767 AIRPORT ROAD, PANAMA CITY, FL, 32405, US
ZIP code: 32405
County: Bay
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1992701049 2005-06-23 2008-04-20 767 AIRPORT RD, PANAMA CITY, FL, 324054000, US 767 AIRPORT RD, PANAMA CITY, FL, 324054000, US

Contacts
Phone +1 850-747-0400
Fax 8509139744

Authorized person
Name MR. RON NMI SAMUELIAN
Role CEO
Phone 8507470400

Taxonomy
Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
License Number 0000745
State FL
Is Primary Yes

Other Provider Identifiers
Issuer BCBS
Number 62N
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTHWEST FLORIDA SURGERY CENTER 401(K) PLAN 2023 593123289 2024-03-11 NORTHWEST FLORIDA SURGERY CENTER 70
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621493
Sponsor’s telephone number 8507470400
Plan sponsor’s address 767 AIRPORT ROAD, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2024-03-11
Name of individual signing RON SAMUELIAN
Valid signature Filed with authorized/valid electronic signature
NORTHWEST FLORIDA SURGERY CENTER 401(K) PLAN 2022 593123289 2023-04-28 NORTHWEST FLORIDA SURGERY CENTER 69
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621493
Sponsor’s telephone number 8507470400
Plan sponsor’s address 767 AIRPORT ROAD, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2023-04-28
Name of individual signing RON SAMUELIAN
Valid signature Filed with authorized/valid electronic signature
NORTHWEST FLORIDA SURGERY CENTER 401(K) PLAN 2021 593123289 2022-04-14 NORTHWEST FLORIDA SURGERY CENTER 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621493
Sponsor’s telephone number 8507470400
Plan sponsor’s address 767 AIRPORT ROAD, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2022-04-14
Name of individual signing RON SAMUELIAN
Valid signature Filed with authorized/valid electronic signature
NORTHWEST FLORIDA SURGERY CENTER 401(K) PLAN 2020 593123289 2021-05-05 NORTHWEST FLORIDA SURGERY CENTER 69
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621493
Sponsor’s telephone number 8507470400
Plan sponsor’s address 767 AIRPORT ROAD, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2021-05-05
Name of individual signing RON SAMUELIAN
Valid signature Filed with authorized/valid electronic signature
NORTHWEST FLORIDA SURGERY CENTER 401(K) PLAN 2019 593123289 2020-07-02 NORTHWEST FLORIDA SURGERY CENTER 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621493
Sponsor’s telephone number 8507470400
Plan sponsor’s address 767 AIRPORT ROAD, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2020-07-02
Name of individual signing RON SAMUELIAN
Valid signature Filed with authorized/valid electronic signature
NORTHWEST FLORIDA SURGERY CENTER 401(K) PLAN 2018 593123289 2019-03-13 NORTHWEST FLORIDA SURGERY CENTER 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621493
Sponsor’s telephone number 8507470400
Plan sponsor’s address 767 AIRPORT ROAD, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2019-03-13
Name of individual signing RON SAMUELIAN
Valid signature Filed with authorized/valid electronic signature
NORTHWEST FLORIDA SURGERY CENTER 401(K) PLAN 2017 593123289 2018-04-03 NORTHWEST FLORIDA SURGERY CENTER 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621493
Sponsor’s telephone number 8507470400
Plan sponsor’s address 767 AIRPORT ROAD, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2018-04-03
Name of individual signing RON SAMUELIAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-03
Name of individual signing RON SAMUELIAN
Valid signature Filed with authorized/valid electronic signature
NORTHWEST FLORIDA SURGERY CENTER 401(K) PLAN 2016 593123289 2017-02-28 NORTHWEST FLORIDA SURGERY CENTER 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621493
Sponsor’s telephone number 8507470400
Plan sponsor’s address 767 AIRPORT ROAD, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2017-02-28
Name of individual signing RON SAMUELIAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-02-28
Name of individual signing RON SAMUELIAN
Valid signature Filed with authorized/valid electronic signature
NORTHWEST FLORIDA SURGERY CENTER 401(K) PLAN 2015 593123289 2016-02-28 NORTHWEST FLORIDA SURGERY CENTER 71
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621493
Sponsor’s telephone number 8507470400
Plan sponsor’s address 767 AIRPORT ROAD, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2016-02-28
Name of individual signing RON SAMUELIAN
Valid signature Filed with authorized/valid electronic signature
NORTHWEST FLORIDA SURGERY CENTER 401(K) PLAN 2014 593123289 2015-05-01 NORTHWEST FLORIDA SURGERY CENTER 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621493
Sponsor’s telephone number 8507470400
Plan sponsor’s address 767 AIRPORT ROAD, PANAMA CITY, FL, 32405

Signature of
Role Plan administrator
Date 2015-05-01
Name of individual signing RON SAMUELIAN
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
TRAN QUANG Dr. President 724 WEST 19TH STREET, PANAMA CITY, FL, 32405
TRAN QUANG Dr. Director 724 WEST 19TH STREET, PANAMA CITY, FL, 32405
Caspary Hans Dr. Vice President 724 West 19th Street, PANAMA CITY, FL, 32405
Caspary Hans Dr. Director 724 West 19th Street, PANAMA CITY, FL, 32405
SAMUELIAN RON Secretary 767 AIRPORT RD, PANAMA CITY, FL
Boyd Ginger Esq. Agent 215 S. MONROE ST., TALLAHASSEE, FL, 32301

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2020-03-05 Boyd, Ginger, Esq. -
REGISTERED AGENT ADDRESS CHANGED 2020-03-05 215 S. MONROE ST., STE. 400, TALLAHASSEE, FL 32301 -
CHANGE OF MAILING ADDRESS 2009-04-22 767 AIRPORT ROAD, PANAMA CITY, FL 32405 -
CHANGE OF PRINCIPAL ADDRESS 1996-02-27 767 AIRPORT ROAD, PANAMA CITY, FL 32405 -

Documents

Name Date
ANNUAL REPORT 2024-02-07
ANNUAL REPORT 2023-01-26
ANNUAL REPORT 2022-03-30
ANNUAL REPORT 2021-04-14
ANNUAL REPORT 2020-03-05
ANNUAL REPORT 2019-03-08
ANNUAL REPORT 2018-02-19
ANNUAL REPORT 2017-02-01
ANNUAL REPORT 2016-03-02
ANNUAL REPORT 2015-01-14

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
339111999 0419700 2013-06-12 767 AIRPORT ROAD, PANAMA CITY, FL, 32405
Inspection Type Planned
Scope Complete
Safety/Health Health
Close Conference 2013-06-12
Emphasis L: SHARPS, P: SHARPS
Case Closed 2013-06-18

Companies related by officers

SAMUELIAN RON

DOCTORS HEALTH CARE, L.L.C. - Inactive
Florida Limited Liability Co. (2000 - 2001)
PROFESSIONAL RESOURCE COMPANY, LLC - Inactive
Florida Limited Liability Co. (2010 - 2016)

Boyd Ginger Esq.

NORTHWEST FLORIDA SURGERY CENTER, LTD. - Active
Domestic Limited Partnership (1993 )

Companies related by address

767 AIRPORT ROAD, PANAMA CITY, FL, 32405, US

NORTHSIDE PROPERTIES, L.L.C. PCWRC, INC.

767 AIRPORT ROAD, PANAMA CITY, FL, 32405, US

NORTHSIDE PROPERTIES, L.L.C. PCWRC, INC.

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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