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FLORIDA AMBULATORY ANESTHESIA, LLC - Florida Company Profile

Company Details

Entity Name: FLORIDA AMBULATORY ANESTHESIA, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

FLORIDA AMBULATORY ANESTHESIA, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 02 Apr 2004 (21 years ago)
Date of dissolution: 28 Sep 2012 (13 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 28 Sep 2012 (13 years ago)
Document Number: L04000025159
FEI/EIN Number 061721757

Federal Employer Identification (FEI) Number assigned by the IRS.

Mail Address: 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414
Address: 1395 STATE ROAD 7, SUITE 100, WELLINGTON, FL, 33414
ZIP code: 33414
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1275640328 2006-08-24 2010-05-14 PO BOX 9117, UNIONDALE, NY, 115559117, US 1395 STATE ROAD 7, SUITE 100, WELLINGTON, FL, 334149326, US

Contacts

Phone +1 800-910-9207
Phone +1 561-422-1950
Fax 5614220997

Authorized person

Name RONALD N SMITH
Role MANAGING DIRECTOR
Phone 5614221950

Taxonomy

Taxonomy Code 207L00000X - Anesthesiology Physician
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 271682800
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FLORIDA AMBULATORY ANESTHESIA, LLC DEFINED BENEFIT PLAN 2011 061721757 2012-10-11 FLORIDA AMBULATORY ANESTHESIA, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 5614220994
Plan sponsor’s address 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414

Plan administrator’s name and address

Administrator’s EIN 061721757
Plan administrator’s name FLORIDA AMBULATORY ANESTHESIA, LLC
Plan administrator’s address 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414
Administrator’s telephone number 5614220994

Signature of

Role Plan administrator
Date 2012-10-11
Name of individual signing RONALD SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-11
Name of individual signing RONALD SMITH
Valid signature Filed with authorized/valid electronic signature
FLORIDA AMBULATORY ANESTHESIA, LLC 401(K) PLAN 2011 061721757 2012-10-11 FLORIDA AMBULATORY ANESTHESIA, LLC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 5614220994
Plan sponsor’s address 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414

Plan administrator’s name and address

Administrator’s EIN 061721757
Plan administrator’s name FLORIDA AMBULATORY ANESTHESIA, LLC
Plan administrator’s address 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414
Administrator’s telephone number 5614220994

Signature of

Role Plan administrator
Date 2012-10-11
Name of individual signing RONALD SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-11
Name of individual signing RONALD SMITH
Valid signature Filed with authorized/valid electronic signature
FLORIDA AMBULATORY ANESTHESIA, LLC 401(K) PLAN 2010 061721757 2011-10-05 FLORIDA AMBULATORY ANESTHESIA, LLC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 5614220994
Plan sponsor’s address 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414

Plan administrator’s name and address

Administrator’s EIN 061721757
Plan administrator’s name FLORIDA AMBULATORY ANESTHESIA, LLC
Plan administrator’s address 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414
Administrator’s telephone number 5614220994

Signature of

Role Plan administrator
Date 2011-10-05
Name of individual signing RONALD SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-05
Name of individual signing RONALD SMITH
Valid signature Filed with authorized/valid electronic signature
FLORIDA AMBULATORY ANESTHESIA, LLC DEFINED BENEFIT PLAN 2010 061721757 2011-10-05 FLORIDA AMBULATORY ANESTHESIA, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 5614220994
Plan sponsor’s address 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414

Plan administrator’s name and address

Administrator’s EIN 061721757
Plan administrator’s name FLORIDA AMBULATORY ANESTHESIA, LLC
Plan administrator’s address 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414
Administrator’s telephone number 5614220994

Signature of

Role Plan administrator
Date 2011-10-05
Name of individual signing RONALD SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-05
Name of individual signing RONALD SMITH
Valid signature Filed with authorized/valid electronic signature
FLORIDA AMBULATORY ANESTHESIA, LLC 401(K) PLAN 2009 061721757 2010-10-01 FLORIDA AMBULATORY ANESTHESIA, LLC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 5614220994
Plan sponsor’s address 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414

Plan administrator’s name and address

Administrator’s EIN 061721757
Plan administrator’s name FLORIDA AMBULATORY ANESTHESIA, LLC
Plan administrator’s address 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414
Administrator’s telephone number 5614220994

Signature of

Role Plan administrator
Date 2010-10-01
Name of individual signing RONALD SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-01
Name of individual signing RONALD SMITH
Valid signature Filed with authorized/valid electronic signature
FLORIDA AMBULATORY ANESTHESIA, LLC DEFINED BENEFIT PLAN 2009 061721757 2010-09-22 FLORIDA AMBULATORY ANESTHESIA, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 5614220994
Plan sponsor’s address 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414

Plan administrator’s name and address

Administrator’s EIN 061721757
Plan administrator’s name FLORIDA AMBULATORY ANESTHESIA, LLC
Plan administrator’s address 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414
Administrator’s telephone number 5614220994

Signature of

Role Plan administrator
Date 2010-09-21
Name of individual signing RONALD SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-21
Name of individual signing RONALD SMITH
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
SMITH RONALD N Managing Member 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414
BHARDWAJ NISHA M Managing Member 11104 GREEN BAYBERRY DRIVE, PALM BEACH GARDENS, FL, 33418
SMITH RONALD N Agent 15761 CEDAR GROVE LANE, WELLINGTON, FL, 33414

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2012-09-28 - -
CHANGE OF PRINCIPAL ADDRESS 2005-02-14 1395 STATE ROAD 7, SUITE 100, WELLINGTON, FL 33414 -
REGISTERED AGENT NAME CHANGED 2005-02-14 SMITH, RONALD N -
REGISTERED AGENT ADDRESS CHANGED 2005-02-14 15761 CEDAR GROVE LANE, WELLINGTON, FL 33414 -
AMENDMENT 2004-12-21 - -

Documents

Name Date
ANNUAL REPORT 2011-04-04
ANNUAL REPORT 2010-01-21
ANNUAL REPORT 2009-02-09
ANNUAL REPORT 2008-01-21
ANNUAL REPORT 2007-01-25
ANNUAL REPORT 2006-02-25
ANNUAL REPORT 2005-02-14
Amendment 2004-12-21
Florida Limited Liabilites 2004-04-02

Date of last update: 03 Apr 2025

Sources: Florida Department of State