| Entity Name: | CRYSTAL RIVER ANESTHESIA ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Apr 2019 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 19 Sep 2022 (2 years ago) |
| Document Number: | L19000112481 |
| FEI/EIN Number | 83-4636756 |
| 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 | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548976525 | 2023-01-24 | 2023-01-24 | 3621 E FOREST DR, INVERNESS, FL, 344530787, US | 3621 E FOREST DR, INVERNESS, FL, 344530787, US | |||||||||||||
|
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| Phone | +1 352-637-2787 |
Authorized person
| Name | JEFF PERRY |
| Role | VP REVENUE CYCLE MANAGEMENT |
| Phone | 5024184700 |
Taxonomy
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| INCORP SERVICES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Stroud Robert SEsq. | Auth | 2 N. Tamiami Trail, Sarasota, FL, 34236 |
| Name | Role | Address |
|---|---|---|
| HYSTAD SAMANTHA | Manager | 1100 BELLEVUE WAY NE, BELLEVUE, WA, 98004 |
| Name | Role | Address |
|---|---|---|
| KREGER JAY | Chief Executive Officer | 1100 BELLEVUE WAY NE, BELLEVUE, WA, 98004 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-17 | 3458 LAKESHORE DRIVE, TALLAHASSEE, FL 32312 | No data |
| LC AMENDMENT | 2022-09-19 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-02-24 | 1100 BELLEVUE WAY NE, Ste 8A #188, BELLEVUE, WA 98004 | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-24 | 1100 BELLEVUE WAY NE, Ste 8A #188, BELLEVUE, WA 98004 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-02-01 |
| LC Amendment | 2022-09-19 |
| ANNUAL REPORT | 2022-02-24 |
| ANNUAL REPORT | 2021-03-16 |
| ANNUAL REPORT | 2020-07-24 |
| Florida Limited Liability | 2019-04-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
