| Entity Name: | WEST COAST SURGICAL GROUP, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 21 Sep 2011 (13 years ago) |
| Date of dissolution: | 03 Apr 2019 (6 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 03 Apr 2019 (6 years ago) |
| Document Number: | L11000108202 |
| FEI/EIN Number | 453677183 |
| Address: | 5953 17TH AVE WEST, BRADENTON, FL, 34209 |
| Mail Address: | 5953 17TH AVE WEST, BRADENTON, FL, 34209 |
| ZIP code: | 34209 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679847529 | 2012-02-23 | 2018-01-24 | PO BOX 14731, BRADENTON, FL, 342804731, US | 5953 17TH AVE W, BRADENTON, FL, 342097836, US | |||||||||||||||||||||||
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| Phone | +1 941-545-4002 |
| Fax | 9417486195 |
| Phone | +1 941-746-8127 |
| Fax | 9417468127 |
Authorized person
| Name | DR. PAIGE KOENIG PENNEBACKER |
| Role | MD |
| Phone | 9417610500 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | ME62365 |
| State | FL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| BLALOCK WALTERS, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| PENNEBACKER PAIGE K | Manager | 5953 17TH AVE WEST, BRADENTON, FL, 34209 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2019-04-03 | No data | No data |
| LC AMENDMENT AND NAME CHANGE | 2014-02-03 | WEST COAST SURGICAL GROUP, PLLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-02-03 | 5953 17TH AVE WEST, BRADENTON, FL 34209 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-02-03 | 802 11TH STREET WEST, BRADENTON, FL 34205 | No data |
| CHANGE OF MAILING ADDRESS | 2014-02-03 | 5953 17TH AVE WEST, BRADENTON, FL 34209 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-02-03 | BLALOCK WALTERS, P.A. | No data |
| LC AMENDMENT | 2011-11-18 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2019-04-03 |
| ANNUAL REPORT | 2018-01-19 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-15 |
| LC Amendment and Name Change | 2014-02-03 |
| ANNUAL REPORT | 2014-01-21 |
| ANNUAL REPORT | 2013-01-23 |
| ANNUAL REPORT | 2012-07-16 |
| LC Amendment | 2011-11-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
