| Entity Name: | FLORIDA GULF-TO-BAY ANESTHESIOLOGY PAIN, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 11 Jun 2007 (18 years ago) |
| Date of dissolution: | 04 Apr 2012 (13 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 04 Apr 2012 (13 years ago) |
| Document Number: | L07000061429 |
| FEI/EIN Number | 75-3243634 |
| Address: | 1 TAMPA GENERAL CIRCLE, SUITE A327, TAMPA, FL 33606 |
| Mail Address: | 1 TAMPA GENERAL CIRCLE, SUITE A327, TAMPA, FL 33606 |
| ZIP code: | 33606 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912105172 | 2007-07-10 | 2009-12-09 | 1 TAMPA GENERAL CIR, A327, TAMPA, FL, 336063571, US | 118 S OREGON AVE, TAMPA, FL, 336061820, US | |||||||||||||||||||||||||
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| Phone | +1 813-844-4396 |
| Fax | 8138444972 |
| Phone | +1 813-253-2273 |
| Fax | 8132532279 |
Authorized person
| Name | DEVANAND MANGAR |
| Role | OWNER/PRESIDENT |
| Phone | 8138444434 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 39348 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MANGAR, DEVANAND | Agent | 1 TAMPA GENERAL CIRCLE, SUITE A327, TAMPA, FL 33606 |
| Name | Role | Address |
|---|---|---|
| MANGAR, DEVANAND | Manager | 1 TAMPA GENERAL CIRCLE, SUITE A327, TAMPA, FL 33606 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2012-04-04 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2009-01-16 | MANGAR, DEVANAND | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-01-16 | 1 TAMPA GENERAL CIRCLE, SUITE A327, TAMPA, FL 33606 | No data |
| CHANGE OF MAILING ADDRESS | 2009-01-16 | 1 TAMPA GENERAL CIRCLE, SUITE A327, TAMPA, FL 33606 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-01-16 | 1 TAMPA GENERAL CIRCLE, SUITE A327, TAMPA, FL 33606 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2012-04-04 |
| ANNUAL REPORT | 2012-01-04 |
| ANNUAL REPORT | 2011-01-04 |
| ANNUAL REPORT | 2010-01-05 |
| ANNUAL REPORT | 2009-01-16 |
| ANNUAL REPORT | 2008-04-23 |
| Florida Limited Liability | 2007-06-11 |
Date of last update: 27 Jan 2025
Sources: Florida Department of State
