| Entity Name: | ANESTHESIA GROUP OF MICROSPINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 31 Oct 2003 (21 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | L03000042155 |
| FEI/EIN Number | 900118217 |
| Address: | 101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL, 32435, US |
| Mail Address: | 101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL, 32435, US |
| ZIP code: | 32435 |
| County: | Walton |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093760449 | 2006-05-24 | 2007-10-09 | 101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL, 324356323, US | 101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL, 324356323, US | |||||||||||||||||||||
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| Phone | +1 850-892-6001 |
| Fax | 8508924212 |
Authorized person
| Name | ANGEL D BARBER IX |
| Role | ADMINISTRATOR |
| Phone | 8508926001 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS NON PAR NUMBER |
| Number | 74903 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BARBER ANGEL D | Agent | 101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL, 32435 |
| Name | Role | Address |
|---|---|---|
| MICROSPINE, INC. | Managing Member | 101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL, 32435 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-03-20 | 101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL 32435 | No data |
| CHANGE OF MAILING ADDRESS | 2007-03-20 | 101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL 32435 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-03-20 | 101 MICROSPINE WAY, DEFUNIAK SPRINGS, FL 32435 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-03-29 |
| ANNUAL REPORT | 2009-01-28 |
| ANNUAL REPORT | 2008-01-09 |
| ANNUAL REPORT | 2007-03-20 |
| ANNUAL REPORT | 2006-01-17 |
| ANNUAL REPORT | 2005-04-19 |
| ANNUAL REPORT | 2004-04-28 |
| Florida Limited Liability | 2003-10-31 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
