| Entity Name: | CAPITAL CITY ANESTHESIA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 05 Oct 2005 (19 years ago) |
| Document Number: | L05000098027 |
| FEI/EIN Number | 20-3593176 |
| Address: | 2910 KERRY FOREST PKWY, SUITE D4, BOX 301, TALLAHASSEE, FL 32309 |
| Mail Address: | 2910 KERRY FOREST PKWY, SUITE D4, BOX 301, TALLAHASSEE, FL 32309 |
| ZIP code: | 32309 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346212669 | 2006-02-02 | 2022-07-21 | P.O. BOX 919030, ORLANDO, FL, 328919030, US | 2010 FLEISCHMANN RD, TALLAHASSEE, FL, 323084599, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 850-656-4277 |
| Fax | 8506564276 |
| Phone | +1 850-552-0608 |
| Fax | 8505520925 |
Authorized person
| Name | DR. PATRICE TALLEY BIDWELL |
| Role | OWNER/PRESIDENT |
| Phone | 8506564277 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BELL, DONALD L | Agent | 1016 SHALIMAR DRIVE, TALLAHASSEE, FL 32312 |
| Name | Role | Address |
|---|---|---|
| BIDWELL, PATRICE TMD | Managing Member | 816 Shell Street, TALLAHASSEE, FL 32303 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2016-08-23 | 2910 KERRY FOREST PKWY, SUITE D4, BOX 301, TALLAHASSEE, FL 32309 | No data |
| CHANGE OF MAILING ADDRESS | 2016-08-23 | 2910 KERRY FOREST PKWY, SUITE D4, BOX 301, TALLAHASSEE, FL 32309 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-06-26 | BELL, DONALD L | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-06-26 | 1016 SHALIMAR DRIVE, TALLAHASSEE, FL 32312 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-02-03 |
| ANNUAL REPORT | 2019-02-10 |
| ANNUAL REPORT | 2018-01-29 |
| ANNUAL REPORT | 2017-01-13 |
| ANNUAL REPORT | 2016-03-08 |
| ANNUAL REPORT | 2015-03-02 |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
