| Entity Name: | CITRUS ANESTHESIA PROVIDERS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Feb 2008 (17 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 17 Jul 2015 (10 years ago) |
| Document Number: | L08000018945 |
| FEI/EIN Number | 262037161 |
| Address: | 3075 West Gulf to Lake Hwy, Lecanto, FL, 34461, US |
| Mail Address: | PO BOX 1300, LECANTO, FL, 34460, US |
| ZIP code: | 34461 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972775906 | 2008-03-31 | 2018-09-17 | PO BOX 1300, LECANTO, FL, 344601300, US | 3075 W GULF TO LAKE HWY, LECANTO, FL, 344619228, US | |||||||||||||||||||||||
|
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| Phone | +1 352-634-2012 |
| Phone | +1 352-326-4014 |
| Fax | 3523264126 |
Authorized person
| Name | DEAN T PAULEY |
| Role | OWNER |
| Phone | 3526342012 |
Taxonomy
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE SHIELD PROVIDER NUMBER |
| Number | G9063 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PAULEY DEAN T | Agent | 3075 West Gulf to Lake Hwy, Lecanto, FL, 34461 |
| Name | Role | Address |
|---|---|---|
| PAULEY DEAN T | Manager | 5266 SOUTH STETSON POINT DRIVE, HOMOSASSA, FL, 34448 |
| Name | Role | Address |
|---|---|---|
| LOWREY LAYNE T | Managing Member | 1105 N PALM SPRINGS TERRACE, CRYSTAL RIVER, FL, 34429 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-04 | PAULEY, DEAN T | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-01-12 | 3075 West Gulf to Lake Hwy, Lecanto, FL 34461 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-01-12 | 3075 West Gulf to Lake Hwy, Lecanto, FL 34461 | No data |
| LC AMENDMENT | 2015-07-22 | No data | No data |
| LC AMENDMENT | 2015-07-17 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2014-11-20 | 3075 West Gulf to Lake Hwy, Lecanto, FL 34461 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-17 |
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-02-06 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-01-31 |
| ANNUAL REPORT | 2020-06-16 |
| ANNUAL REPORT | 2019-02-10 |
| ANNUAL REPORT | 2018-01-12 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-01-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
