Provider Profile

MIDDLEBURG SURGERY CENTER

Ambulatory Surgical Center

FACILITY PROFILE

Accredited by: Accreditation Association for Ambulatory Health Care
Street Address
  • 1821 BLANDING BLVD STE 2
    MIDDLEBURG, FL 32068
    County: Clay
  • Phone: (904) 467-0979
Mailing Address
  • 1821 BLANDING BLVD, STE 2
    MIDDLEBURG, FL 32068
    County: Clay
  • Phone: (904) 467-0979
AHCA Reports
Inspection Reports
Inspection Details
Consumer Guides
A Patient's Guide to a Hospital Stay
Patient Safety
Health Care Advance Directives
Facility Information:
Facility/Provider Type:Ambulatory Surgical Center
Administrator:RACHEL CHRISTINE WOLF
Financial Officer:CHRISTOPHER GLENN
Owner/Licensee:MIDDLEBURG SURGERY CENTER LLC
Owner/Licensee Since:3/19/2019

NamePositionOwnership
PHYSICIANS GROUP SERVICES PA100%
ANDREW CHRISTMANBOARD MEMBER/OFFICER0%
GREGG TABOHBOARD MEMBER/OFFICER0%
KENNETH ANGUS POWELLBOARD MEMBER/OFFICER0%
MICHAEL ANDREW GREENEBOARD MEMBER/OFFICER0%
Profit Status:For-Profit
Management Company:PCP FINANCIAL
Manager Since:3/19/2019

NamePositionOwnership
KENNETH ANGUS POWELL71%
CAROL JEAN MOSLEYBOARD MEMBER/OFFICER7%
ALAN EDWARD MILLLER5%
FERDINAND JOSEPH FORMOSO5%
ZANDA MORGAN CHANDLERBOARD MEMBER/OFFICER5%
BRIDGET LANCASTER ROBERTSBOARD MEMBER/OFFICER2%
CHARLES FLETCHER RAGLANDBOARD MEMBER/OFFICER2%
Licensed Beds:Not Available
Bed Types:Operating Rooms: 2
Recovery Beds: 5
AHCA Number (File Number):14960940
AHCA Field Office:04
License Number:1437
Current License Effective:12/12/2024
Current License Expires:12/11/2026
License Status:LICENSED
Services/Characteristics

Not Available

Legal Actions
Please note the legal actions above may have been issued to a prior owner. The Final Order displays the name of the licensee responsible for the legal action that was taken.
Date Initiated Case # Case Type Violation Fine Amount Date Imposed
Change of ownership occurred 12/12/2024

Important information and facility/provider definitions can be found in the Glossary.

Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.