0001720628-17-000001.txt : 20171024 0001720628-17-000001.hdr.sgml : 20171024 20171024162504 ACCESSION NUMBER: 0001720628-17-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20171024 DATE AS OF CHANGE: 20171024 EFFECTIVENESS DATE: 20171024 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Surgery Center at TGH Brandon Healthplex, LLC CENTRAL INDEX KEY: 0001720628 IRS NUMBER: 611795393 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-297330 FILM NUMBER: 171151190 BUSINESS ADDRESS: STREET 1: 10740 PALM RIVER ROAD STREET 2: SUITE 200 CITY: TAMPA STATE: FL ZIP: 33609 BUSINESS PHONE: 813-660-6600 MAIL ADDRESS: STREET 1: 10740 PALM RIVER ROAD STREET 2: SUITE 200 CITY: TAMPA STATE: FL ZIP: 33609 D 1 primary_doc.xml X0708 D LIVE 0001720628 Surgery Center at TGH Brandon Healthplex, LLC 10740 PALM RIVER ROAD SUITE 200 TAMPA FL FLORIDA 33609 813-660-6600 FLORIDA None None Limited Liability Company true 2016 . Tampa General Hospital One Tampa General Circle Tampa FL FLORIDA 33606 Promoter . TGH Ancillary Holding Company One Tampa General Circle Tampa FL FLORIDA 33606 Promoter Class C and Administrative Member of Issuer Mark Anderson 10740 Palm River Road Suite 200 Tampa FL FLORIDA 33606 Executive Officer Director Class C Governing Board Member and President of Issuer Raviender Bukkapatnam, M.D. 10740 Palm River Road Suite 200 Tampa FL FLORIDA 33606 Director Class C Governing Board Member of Issuer Vince Perron, M.D. 10740 Palm River Road Suite 200 Tampa FL FLORIDA 33606 Director Class C Governing Board Member of Issuer Chris Roederer 10740 Palm River Road Suite 200 Tampa FL FLORIDA 33606 Executive Officer President of Class C and Administrative Member Scott Arnold 10740 Palm River Road Suite 200 Tampa FL FLORIDA 33606 Executive Officer Secretary of Class C and Administrative Member Anthony Escobio 10740 Palm River Road Suite 200 Tampa FL FLORIDA 33606 Executive Officer Treasurer of Class C and Administrative Member Hospitals and Physicians Decline to Disclose 06b false 2017-10-09 false true false 25000 25000 25000 0 false 1 0 0 0 The gross proceeds from the sale of the Unit by the Issuer will be used to redeem from the Class C Member one Unit at a price equal to the price at which such Units is purchased hereunder. false Surgery Center at TGH Brandon Healthplex, LLC /s/ Mark Anderson Mark Anderson President of Issuer 2017-10-24