| Entity Name: | OSCEOLA GASTROENTEROLOGY ANESTHESIA ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Jan 2017 (8 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 06 Sep 2022 (2 years ago) |
| Document Number: | L17000009982 |
| FEI/EIN Number | 36-4857219 |
| Address: | 1100 Bellevue Way NE, Suite 8A #188, BELLEVUE, WA, 98004, US |
| Mail Address: | 1100 Bellevue Way NE, Suite 8A #188, BELLEVUE, WA, 98004, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124567706 | 2017-02-16 | 2024-04-10 | PO BOX 947513, ATLANTA, GA, 303947513, US | 715 OAK COMMONS BLVD, KISSIMMEE, FL, 347414213, US | |||||||||||||||||||||||
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| Phone | +1 800-242-5080 |
| Fax | 7279007770 |
| Phone | +1 407-931-2816 |
| Fax | 8666658561 |
Authorized person
| Name | JEFF PERRY |
| Role | MANAGER |
| Phone | 5024184700 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | No |
| Name | Role |
|---|---|
| BLALOCK WALTERS, P.A. | 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 |
|---|---|---|---|---|---|---|
| G17000072958 | CRH ANESTHESIA | ACTIVE | 2017-07-06 | 2027-12-31 | No data | 227 BELLEVUE WAY NE, #188, BELLEVUE, WA, 98004 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2022-09-06 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-08 | 1100 Bellevue Way NE, Suite 8A #188, BELLEVUE, WA 98004 | No data |
| CHANGE OF MAILING ADDRESS | 2019-02-08 | 1100 Bellevue Way NE, Suite 8A #188, BELLEVUE, WA 98004 | No data |
| LC AMENDMENT | 2017-03-24 | No data | No data |
| MERGER | 2017-03-14 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 700000169447 |
| 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 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-02-28 |
| LC Amendment | 2017-03-24 |
| Merger | 2017-03-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
