Provider Profile

ADVENTHEALTH SURGERY CENTER PORT ORANGE

Ambulatory Surgical Center

FACILITY PROFILE

Accredited by: Accreditation Association for Ambulatory Health Care
Street Address
  • 1185 DUNLAWTON AVE STE 100
    PORT ORANGE, FL 32127
    County: Volusia
  • Phone: (386) 777-7151
Mailing Address
  • 1185 DUNLAWTON AVE, STE 100
    PORT ORANGE, FL 32127
    County: Volusia
  • Phone: (386) 777-7151
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:VICTORIA MICHELLE RIOUX
Financial Officer:CORY DOMAYER
Owner/Licensee:PORT ORANGE ENDOSCOPY & SURGERY CENTER LLC
Owner/Licensee Since:2/12/2007

NamePositionOwnership
MEMORIAL HEALTH SYSTEMS INC100%
CORY DOMAYERBOARD MEMBER/OFFICER0%
DAVID WEISBOARD MEMBER/OFFICER0%
JAIME KABANUKBOARD MEMBER/OFFICER0%
JOHN TOLLANDBOARD MEMBER/OFFICER0%
SHYROLL MORRISBOARD MEMBER/OFFICER0%
Profit Status:For-Profit
Management Company:Not Available
Manager Since:Not Available
Licensed Beds:Not Available
Bed Types:Operating Rooms: 1
Recovery Beds: 3
AHCA Number (File Number):14960555
AHCA Field Office:04
License Number:1227
Current License Effective:4/1/2025
Current License Expires:3/31/2027
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
12/9/20242024016281FineReporting$300.001/3/2025
Change of ownership occurred 4/1/2023
2/18/20092009001733FineApplication$500.002/18/2009

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.