| Entity Name: | MARTIN COUNTY ANESTHESIA GROUP, PL |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 12 Dec 2000 (24 years ago) |
| Date of dissolution: | 28 Jul 2014 (11 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 28 Jul 2014 (11 years ago) |
| Document Number: | L00000015399 |
| FEI/EIN Number | 651061717 |
| Address: | 200 SE HOSPITAL AVE, STUART, FL, 34994 |
| Mail Address: | 2381 sw Racquet Club Dr, Palm City, FL, 34990, US |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487606075 | 2006-05-16 | 2012-10-11 | 75 REMITTANCE DR, SUITE 6634, CHICAGO, IL, 606756634, US | 200 SE HOSPITAL AVE, STUART, FL, 349942346, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 877-538-4594 |
| Fax | 8666652702 |
| Phone | +1 772-287-5200 |
Authorized person
| Name | DR. GEORGE E MCLAIN |
| Role | PRESIDENT |
| Phone | 7722875200 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CIGNA GROUP NUMBER |
| Number | 0888797 |
| State | FL |
| Issuer | MEDICAID |
| Number | 252978500 |
| State | FL |
| Issuer | RR MEDICARE GROUP# |
| Number | CH9103 |
| State | FL |
| Issuer | BCBS OF FL GR NUMBER |
| Number | 77336 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FOX M LANNING | Agent | 3473 SE WILLOUGHBY BLVD, STUART, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| MCLAIN, JR GEORGE E | President | 3245 SW 34TH ST, OCALA, FL, 34478 |
| Name | Role | Address |
|---|---|---|
| HARRIS DAVID | Vice President | 3245 SW 34TH ST, OCALA, FL, 34478 |
| Name | Role | Address |
|---|---|---|
| MCLAIN, JR GEORGE E | Secretary | 3245 SW 34TH ST, OCALA, FL, 34478 |
| Name | Role | Address |
|---|---|---|
| PERLMAN MARK L | Treasurer | 3245 SW 34TH ST, OCALA, FL, 33478 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2014-07-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2014-04-26 | 200 SE HOSPITAL AVE, STUART, FL 34994 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-08-30 | FOX, M LANNING | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-08-30 | 3473 SE WILLOUGHBY BLVD, STUART, FL 34994 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-05 | 200 SE HOSPITAL AVE, STUART, FL 34994 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2014-07-28 |
| ANNUAL REPORT | 2014-04-26 |
| ANNUAL REPORT | 2013-03-18 |
| ANNUAL REPORT | 2012-08-30 |
| ANNUAL REPORT | 2012-02-10 |
| ANNUAL REPORT | 2011-02-23 |
| ANNUAL REPORT | 2010-04-05 |
| ANNUAL REPORT | 2009-03-12 |
| ANNUAL REPORT | 2008-03-05 |
| ANNUAL REPORT | 2007-04-02 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
