| Entity Name: | OLIVER M HASEK LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 04 Apr 2013 (12 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | L13000049981 |
| FEI/EIN Number | 20-4348678 |
| Address: | 7205 Thomas Dr E1906, Panama City Beach, FL, 32408, US |
| Mail Address: | PO BOX 27357, PANAMA CITY, FL, 32411, US |
| ZIP code: | 32408 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417395864 | 2013-06-07 | 2013-06-07 | 202 DOCTORS DRIVE, PANAMA CITY, FL, 32405, US | 202 DOCTORS DRIVE, PANAMA CITY, FL, 32405, US | |||||||||||||||||||||||||||||||
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| Phone | +1 850-234-7961 |
| Fax | 8502358948 |
Authorized person
| Name | DR. OLIVER M HASEK |
| Role | OWNER |
| Phone | 8502358948 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 370002000 |
| State | FL |
| Issuer | MEDICARE |
| Number | 141863 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HASEK MARTIN | Agent | 7205 Thomas Dr, E 1906, Panama City Beach, FL, 32408 |
| Name | Role | Address |
|---|---|---|
| Hasek Martin Jr. | President | P.O. BOX 27357, PANAMA CICY BEACH, FL, 32411 |
| Name | Role | Address |
|---|---|---|
| HASEK SANDRA | Vice President | P.O. BOX 27357, PANAMA CITY BEACH, FL, 32411 |
| Name | Role |
|---|---|
| NITRAM MANAGEMENT, LLC | Manager |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-05-04 | 7205 Thomas Dr, E 1906, Panama City Beach, FL 32408 | No data |
| REINSTATEMENT | 2020-05-04 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-04 | 7205 Thomas Dr E1906, Panama City Beach, FL 32408 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| REINSTATEMENT | 2016-10-18 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-18 | HASEK, MARTIN | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2020-05-04 |
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-04-30 |
| REINSTATEMENT | 2016-10-18 |
| ANNUAL REPORT | 2014-03-28 |
| Florida Limited Liability | 2013-04-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
