| Entity Name: | CRH ANESTHESIA OF CAPE CORAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Jul 2015 (10 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 06 Sep 2022 (2 years ago) |
| Document Number: | L15000124079 |
| FEI/EIN Number | 47-4568202 |
| Address: | 1100 BELLEVUE WAY NE, STE 8A # 188, BELLEVUE, WA, 98004, US |
| Mail Address: | 1100 BELLEVUE WAY NE, STE 8A # 188, BELLEVUE, WA, 98004, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922474881 | 2015-08-14 | 2024-04-10 | 3414 PEACHTREE RD NE STE 340, ATLANTA, GA, 303261137, US | 625 DEL PRADO BLVD S, CAPE CORAL, FL, 339902667, US | |||||||||||||||||||||||
|
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| Phone | +1 425-803-3885 |
| Fax | 8666658561 |
| Phone | +1 239-772-3636 |
| Fax | 2397725073 |
Authorized person
| Name | JEFF PERRY |
| Role | MANAGER |
| Phone | 5024184700 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | No |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CRH ANESTHESIA OF CAPE CORAL, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| Kreger Jay | Chief Executive Officer | 1100 Bellevue Way NE, Bellevue, WA, 98004 |
| Name | Role | Address |
|---|---|---|
| SAMANTHA HYSTAD | Manager | 1100 BELLEVUE WAY NE, BELLEVUE, WA, 98004 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000086455 | CRH ANESTHESIA | EXPIRED | 2016-08-15 | 2021-12-31 | No data | 4754 E STATE ROAD 64, BRADENTON, FL, 34208 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-01 | 1100 BELLEVUE WAY NE, STE 8A # 188, BELLEVUE, WA 98004 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-01 | 1100 BELLEVUE WAY NE, STE 8A # 188, BELLEVUE, WA 98004 | No data |
| LC AMENDMENT | 2022-09-06 | No data | No data |
| LC AMENDMENT | 2019-10-18 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-04-18 | CRH Anesthesia of Cape Coral, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-02-01 |
| LC Amendment | 2022-09-06 |
| ANNUAL REPORT | 2022-02-24 |
| ANNUAL REPORT | 2021-03-11 |
| ANNUAL REPORT | 2020-01-23 |
| LC Amendment | 2019-10-18 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-03-27 |
| ANNUAL REPORT | 2017-04-18 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
