| Entity Name: | AMS OF CRESTVIEW, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 07 Dec 2011 (13 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 18 Oct 2012 (12 years ago) |
| Document Number: | L11000137945 |
| FEI/EIN Number | 45-4045849 |
| Address: | 362 GULF BREEZE PARKWAY, 116, GULF BREEZE, FL 32561 |
| Mail Address: | 362 GULF BREEZE PARKWAY, 116, GULF BREEZE, FL 32561 |
| ZIP code: | 32561 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588927982 | 2012-06-20 | 2021-10-13 | PO BOX 919387, ORLANDO, FL, 328910001, US | 28 N PALAFOX ST, PENSACOLA, FL, 325025626, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 866-653-2540 |
Authorized person
| Name | DAVID W. SIMPSON |
| Role | MEMBER |
| Phone | 8666532540 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | No |
| Name | Role |
|---|---|
| CROSS STREET CORPORATE SERVICES, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| SIMPSON, M.D., DAVID W. | Manager | 362 GULF BREEZE PARKWAY, 116 GULF BREEZE, FL 32561 |
| BARTER, AARON | Manager | 362 GULF BREEZE PARKWAY, 116 GULF BREEZE, FL 32561 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-10-30 | 50 CENTRAL AVENUE,, 8TH FLOOR,, SARASOTA, FL 34236 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-26 | 362 GULF BREEZE PARKWAY, 116, GULF BREEZE, FL 32561 | No data |
| CHANGE OF MAILING ADDRESS | 2018-04-26 | 362 GULF BREEZE PARKWAY, 116, GULF BREEZE, FL 32561 | No data |
| REINSTATEMENT | 2012-10-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-04-05 |
| ANNUAL REPORT | 2020-03-05 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-26 |
| ANNUAL REPORT | 2017-03-09 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-03-03 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
