| Entity Name: | CONCH REPUBLIC ANESTHESIA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 15 Feb 2011 (14 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | L11000019984 |
| FEI/EIN Number | 263799962 |
| Address: | 931 TOPPINO DRIVE, KEY WEST, FL, 33040 |
| Mail Address: | 1107 KEY PLAZA #289, KEY WEST, FL, 33040-4077 |
| ZIP code: | 33040 |
| County: | Monroe |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932408705 | 2011-03-19 | 2014-03-25 | 1107 KEY PLZ # 289, KEY WEST, FL, 330404077, US | 931 TOPPINO DR, KEY WEST, FL, 330404269, US | |||||||||||||||||
|
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| Phone | +1 305-453-6521 |
Authorized person
| Name | DR. PATRICK J BRUSCIA |
| Role | OWNER |
| Phone | 3054536521 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| License Number | OS 9660 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BRUSCIA PATRICK JD.O. | Agent | 931 TOPPINO DRIVE, KEY WEST, FL, 33040 |
| Name | Role | Address |
|---|---|---|
| BRUSCIA PATRICK JD.O. | Managing Member | 1107 KEY PLAZA #289, KEY WEST, FL, 330404077 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-02-03 | BRUSCIA, PATRICK J, D.O. | No data |
| CHANGE OF MAILING ADDRESS | 2012-11-20 | 931 TOPPINO DRIVE, KEY WEST, FL 33040 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-03-25 |
| ANNUAL REPORT | 2015-02-15 |
| ANNUAL REPORT | 2014-02-01 |
| ANNUAL REPORT | 2013-02-03 |
| ANNUAL REPORT | 2012-03-30 |
| ADDRESS CHANGE | 2011-05-19 |
| ADDRESS CHANGE | 2011-05-02 |
| Florida Limited Liability | 2011-02-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
