| Entity Name: | SUNBELT ANESTHESIA SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Dec 2012 (12 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 05 Dec 2016 (8 years ago) |
| Document Number: | L12000158430 |
| FEI/EIN Number | 90-0919535 |
| Address: | 322 Scenic Point Lane, Fleming Island, FL, 32003, US |
| Mail Address: | 1880 East West Parkway, #8513, Fleming Island, FL, 32006-9998, US |
| ZIP code: | 32003 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205172079 | 2012-12-21 | 2022-07-19 | PO BOX 25801, TAMPA, FL, 336225801, US | 690 MAJESTIC EAGLE DR, PONTE VEDRA, FL, 320810611, US | |||||||||||||||||||||||||
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| Phone | +1 888-851-4642 |
| Fax | 2403423837 |
| Phone | +1 904-412-2593 |
| Fax | 8666336132 |
Authorized person
| Name | NICHOLAS M KALYNYCH |
| Role | MANAGING MEMBER |
| Phone | 9044122593 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUNBELT ANESTHESIA SERVICES 401(K) PLAN | 2017 | 900919535 | 2018-09-26 | SUNBELT ANESTHESIA SERVICES, LLC | 0 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| Kalynych Nicholas MDr. | Agent | 322 Scenic Point Lane, Fleming Island, FL, 32003 |
| Name | Role | Address |
|---|---|---|
| KALYNYCH NICHOLAS M | Managing Member | 322 Scenic Point Lane, Fleming Island, FL, 32003 |
| CUSHENBERY CAMERON S | Managing Member | 3910 CHARTER HOUSE DRIVE, JACKSONVILLE, FL, 32224 |
| De Leon Efrain | Managing Member | 2115 Romeo Point Lane, Fleming Island, FL, 32003 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-07 | 322 Scenic Point Lane, Fleming Island, FL 32003 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-07 | 322 Scenic Point Lane, Fleming Island, FL 32003 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-12 | 322 Scenic Point Lane, Fleming Island, FL 32003 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-03-08 | Kalynych, Nicholas M, Dr. | No data |
| LC AMENDMENT | 2016-12-05 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-02-21 |
| ANNUAL REPORT | 2019-02-19 |
| ANNUAL REPORT | 2018-03-08 |
| ANNUAL REPORT | 2017-04-21 |
| LC Amendment | 2016-12-05 |
| ANNUAL REPORT | 2016-05-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
