| Entity Name: | WEST FLORIDA CARDIAC ANESTHESIA SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 06 Jun 2013 (12 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | L13000081920 |
| Address: | 2010 59TH STREET WEST, SUITE 4650, BRADENTON, FL, 34209, US |
| Mail Address: | 2010 59TH STREET WEST, SUITE 4650, BRADENTON, FL, 34209, US |
| ZIP code: | 34209 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114369600 | 2013-07-24 | 2013-07-24 | PO BOX 31603, TAMPA, FL, 336313603, US | 21298 OLEAN BLVD, PORT CHARLOTTE, FL, 339526705, US | |||||||||||||||
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| Phone | +1 941-360-1566 |
| Fax | 9413589818 |
Authorized person
| Name | EDWARD A. DEFREITAS |
| Role | MEMBER |
| Phone | 9417983524 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DORMAN LORI M | Agent | 515 9TH STREET EAST, BRADENTON, FL, 34208 |
| Name | Role | Address |
|---|---|---|
| KOSELAK DENNIS | President | 2010 59TH STREET W, SUITE 4650, BRADENTON, FL, 34209 |
| Name | Role | Address |
|---|---|---|
| DEFREITAS EDWARD | Vice President | 2010 59TH STREET W, SUITE 4650, BRADENTON, FL, 34209 |
| GIBSON TOBIAS | Vice President | 2010 59TH STREET W, SUITE 4650, BRADENTON, FL, 34209 |
| OLSON SUZANNE | Vice President | 2010 59TH STREET W, SUITE 4650, BRADENTON, FL, 34209 |
| SMITH UHURA MD | Vice President | 2010 59TH STREET W, SUITE 4650, BRADENTON, FL, 34209 |
| DAROLD PETER MD | Vice President | 2010 59TH STREET W, SUITE 4650, BRADENTON, FL, 34209 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2013-06-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
