| Entity Name: | GULFSHORE ANESTHESIA SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 11 Oct 2012 (12 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | L12000129628 |
| FEI/EIN Number | 46-1162426 |
| Address: | 1064 GOODLETTE ROAD, NAPLES, FL, 34102 |
| Mail Address: | 1064 GOODLETTE ROAD, NAPLES, FL, 34102 |
| ZIP code: | 34102 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184963795 | 2013-02-04 | 2021-09-03 | 1064 GOODLETTE RD, NAPLES, FL, 341025449, US | 1064 GOODLETTE RD, NAPLES, FL, 341025449, US | |||||||||||||||||||||||||||
|
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| Phone | +1 239-649-1186 |
| Fax | 2392624367 |
Authorized person
| Name | DR. RAYMOND W PHILLIPS |
| Role | PRESIDENT |
| Phone | 2396491186 |
Taxonomy
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| License Number | ARNP2027442 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| License Number | ARNP9330297 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| JARA SANDRA M | Agent | 1064 GOODLETTE ROAD, NAPLES, FL, 34102 |
| Name | Role | Address |
|---|---|---|
| Rivera Gustavo DMD | Owne | 1064 GOODLETTE ROAD, NAPLES, FL, 34102 |
| Jara Sandra MMD | Owne | 1064 Goodlette Road, Naples, FL, 34102 |
| Urbina Rafael A.MD | Owne | 1064 Goodlette Road, Naples, FL, 34102 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-02-16 | JARA, SANDRA M | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-07-13 |
| ANNUAL REPORT | 2022-02-16 |
| ANNUAL REPORT | 2021-03-19 |
| ANNUAL REPORT | 2020-02-10 |
| ANNUAL REPORT | 2019-04-05 |
| AMENDED ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2018-01-08 |
| ANNUAL REPORT | 2017-01-17 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-07 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
