| Entity Name: | MDA ANESTHESIA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Nov 2019 (5 years ago) |
| Document Number: | L19000262441 |
| FEI/EIN Number | 84-3561289 |
| Address: | 2326 S CONGRESS AVE, SUITE 2D, WEST PALM BEACH, FL, 33406, UN |
| Mail Address: | 2326 S CONGRESS AVE, SUITE 2D, WEST PALM BEACH, FL, 33406, UN |
| ZIP code: | 33406 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336784115 | 2019-11-15 | 2023-08-01 | 2326 S CONGRESS AVE STE 2D, WEST PALM BEACH, FL, 334067614, US | 39200 HOOKER HWY, BELLE GLADE, FL, 334305368, US | |||||||||||||||||||||||
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| Phone | +1 561-801-1223 |
| Phone | +1 561-707-9149 |
Authorized person
| Name | DANIELA GHIRAGOSSIAN |
| Role | ADMINISTRATOR |
| Phone | 5612686509 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Name | Role |
|---|---|
| HEALTHCARE & GENERAL LEGAL RESOURCES LLC | Agent |
| Name | Role |
|---|---|
| BLUE MEDICAL HOLDINGS, LLC | Owne |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-01-31 | Healthcare & General Legal Resources LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| AMENDED ANNUAL REPORT | 2023-02-27 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-01-04 |
| ANNUAL REPORT | 2020-05-11 |
| Florida Limited Liability | 2019-11-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
