| Entity Name: | MILLS AVE ANESTHESIA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Oct 2011 (13 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 03 Feb 2022 (3 years ago) |
| Document Number: | L11000115318 |
| FEI/EIN Number | 453570881 |
| Mail Address: | 555 Winderley Place, Maitland, FL, 32751, US |
| Address: | 1825 N MILLS AVE, ORLANDO, FL, 32803, US |
| ZIP code: | 32803 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861777971 | 2011-10-20 | 2024-07-15 | 1825 N MILLS AVE, ORLANDO, FL, 328031853, US | 1825 N MILLS AVE, ORLANDO, FL, 328031853, US | |||||||||||||||||||||||||||
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| Phone | +1 407-206-2375 |
| Fax | 4072062377 |
Authorized person
| Name | MARGIE A BRILL |
| Role | MANAGING MEMBER |
| Phone | 4078938215 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | IT884A |
| State | FL |
| Issuer | MEDICAID |
| Number | 113494000 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| LEHR JOHN T | Manager | 1825 N MILLS AVE, ORLANDO, FL, 32803 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-03-02 | 1825 N MILLS AVE, ORLANDO, FL 32803 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-26 | 1825 N MILLS AVE, ORLANDO, FL 32803 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-01-26 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-26 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | No data |
| LC AMENDMENT | 2022-02-03 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-03-02 |
| Reg. Agent Change | 2023-01-26 |
| ANNUAL REPORT | 2022-03-03 |
| LC Amendment | 2022-02-03 |
| AMENDED ANNUAL REPORT | 2021-12-17 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-01-28 |
| ANNUAL REPORT | 2018-01-10 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
