| Entity Name: | WEST FLORIDA ANESTHESIA TRAUMA SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 15 Mar 2011 (14 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | L11000031543 |
| FEI/EIN Number | 45-0818535 |
| Address: | 2010 59TH STREET W, SUITE 4650, BRADENTON, FL 34209 |
| Mail Address: | 2010 59TH STREET W, SUITE 4650, BRADENTON, FL 34209 |
| ZIP code: | 34209 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619262813 | 2011-06-15 | 2013-05-16 | PO BOX 31306, TAMPA, FL, 336313306, US | 2010 59TH ST W, STE 4650, BRADENTON, FL, 342094616, US | |||||||||||||||||
|
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| Phone | +1 941-798-3524 |
Authorized person
| Name | EDWARD DEFREITAS |
| Role | MEMBER MANAGER |
| Phone | 9417983524 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| KOSELAK, DENNIS | Agent | 2010 59TH ST W, SUITE 4650, BRADENTON, FL 34209 |
| Name | Role | Address |
|---|---|---|
| KOSELAK, DENNIS | President | 2010 59TH STREET W, SUITE 4650, BRADENTON, FL 34209 |
| Name | Role | Address |
|---|---|---|
| GIBSON, TOBIAS | Vice President | 2010 59TH ST W, SUITE 4650, BRADENTON, FL 34209 |
| OLSON, SUZANNE | Vice President | 2010 59TH ST W, SUITE 4650, BRADENTON, FL 34209 |
| DaRold, Peter | Vice President | 2010 59TH STREET W, SUITE 4650 BRADENTON, FL 34209 |
| Name | Role | Address |
|---|---|---|
| FLECK, MELISSA J | Secretary | 2010 59TH ST W, SUITE 4650, BRADENTON, FL 34209 |
| Name | Role | Address |
|---|---|---|
| RAVVIN, MIKHAIL | Treasurer | 2010 59TH ST W, SUITE 4650, BRADENTON, FL 34209 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-01-18 | 2010 59TH STREET W, SUITE 4650, BRADENTON, FL 34209 | No data |
| CHANGE OF MAILING ADDRESS | 2012-01-18 | 2010 59TH STREET W, SUITE 4650, BRADENTON, FL 34209 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-01-18 | KOSELAK, DENNIS | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-01-18 | 2010 59TH ST W, SUITE 4650, BRADENTON, FL 34209 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-01-08 |
| ANNUAL REPORT | 2014-01-23 |
| ANNUAL REPORT | 2013-01-17 |
| ANNUAL REPORT | 2012-01-18 |
| Florida Limited Liability | 2011-03-15 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
