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PREMIER RADIATION ONCOLOGY ASSOCIATES, L.L.C. - Florida Company Profile

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Company Details

Entity Name: PREMIER RADIATION ONCOLOGY ASSOCIATES, L.L.C.
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 28 Feb 2020 (6 years ago)
Document Number: L20000063937
FEI/EIN Number 844861779
Address: 3155 N MCMULLEN BOOTH RD, CLEARWATER, FL, 33761, US
Mail Address: 3155 N MCMULLEN BOOTH RD, CLEARWATER, FL, 33761, US
ZIP code: 33761
City: Clearwater
County: Pinellas
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
GAUWITZ MICHAEL D Manager 3155 N MCMULLEN BOOTH ROAD, CLEARWATER, FL, 33761
ATLOOS TAGHRID A Manager 3155 N MCMULLEN BOOTH RD, CLEARWATER, FL, 33761
GASSMAN ALAN S Agent 1245 COURT STREET, CLEARWATER, FL, 33756

National Provider Identifier

NPI Number:
1306471552
Certification Date:
2020-09-28

Authorized Person:

Name:
AUBRAE RUSSOLELLO
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
No
Selected Taxonomy:
2085R0001X - Radiation Oncology Physician
Is Primary:
Yes

Contacts:

Fax:
7276694308

Form 5500 Series

Employer Identification Number (EIN):
844861779
Plan Year:
2024
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
21
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
21
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
21
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
20
Sponsors Telephone Number:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G25000076981 PREMIER CANCER CENTER ACTIVE 2025-06-16 2030-12-31 - 3155 N MCMULLEN BOOTH RD, CLEARWATER, FL, 33761
G25000050979 PREMIER ACTIVE 2025-04-15 2030-12-31 - 3155 N MCMULLEN BOOTH ROAD, CLEARWATER, FL, 33761
G25000050982 PREMIER RADIATION THERAPY CENTER ACTIVE 2025-04-15 2030-12-31 - 3155 N MCMULLEN BOOTH ROAD, CLEARWATER, FL, 33761
G25000050984 PREMIER RADIOTHERAPY ACTIVE 2025-04-15 2030-12-31 - 3155 N MCMULLEN BOOTH ROAD, CLEARWATER, FL, 33761
G25000050985 PREMIER RADIOTHERAPY INSTITUTE ACTIVE 2025-04-15 2030-12-31 - 3155 N MCMULLEN BOOTH ROAD, CLEARWATER, FL, 33761
G23000031980 CLEARWATER PREMIER RADIATION ONCOLOGY ACTIVE 2023-03-09 2028-12-31 - 3155 MCMULLEN BOOTH ROAD, CLEARWATER, FL, 33761
G20000061586 COUNTRYSIDE CANCER CENTER ACTIVE 2020-06-03 2025-12-31 - 3155 MCMULLEN BOORTH ROAD, CLEARWATER, FL, 33761

Documents

Name Date
ANNUAL REPORT 2024-03-06
ANNUAL REPORT 2023-03-03
ANNUAL REPORT 2022-03-24
ANNUAL REPORT 2021-01-09
Florida Limited Liability 2020-02-28

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Date of last update: 03 Aug 2025

Sources: Florida Department of State