Detail by Officer/Registered Agent Name

Florida Limited Liability Company

AMBULATORY SURGERY ASSOCIATES OF CLERMONT, LLC

Filing Information
L04000074562 20-1767381 10/14/2004 10/15/2004 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 09/14/2007 NONE
Principal Address
10345 ORANGEWOOD BLVD
ORLANDO, FL 32821
Mailing Address
10345 ORANGEWOOD BLVD
ORLANDO, FL 32821
Registered Agent Name & Address CENTRAL FLORIDA PHYSIATRISTS, P.A.
10345 ORANGEWOOD BLVD
ORLANDO, FL 32821
Authorized Person(s) Detail Name & Address

Title MGRM

LUCAS, DAVID M.D
235 CITRUS TOWER BLVD, SUITE 102
CLERMONT, FL 34711

Title MGRM

FISCHER, FRANK III,M.D
1420 TOUCHTON LN, S.E.
WINTER HAVEN, FL 33884

Title MGRM

NOWICKI, KEVIN M.D.
12113 CRESCENT COVE COURT
WINDERMERE, FL 34786

Title MGRM

IMFELD, MATT M.D.
10345 ORANGEWOOD BLVD
ORLANDO, FL 32821

Title MGRM

TOPPINO, MAYSSA M.D.
PO BOX 687
MINNEOLA, FL 34755

Annual Reports
Report YearFiled Date
2005 02/16/2005
2006 07/11/2006