| Entity Name: | MOBILE ANESTHESIA ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Jul 2020 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 08 Mar 2024 (a year ago) |
| Document Number: | L20000208877 |
| FEI/EIN Number | 650499574 |
| Address: | 111 SE OSCEOLA ST SUITE 201, STUART, FL, 34994, US |
| Mail Address: | 111 SE OSCEOLA ST SUITE 201, STUART, FL, 34994, US |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295776243 | 2006-06-09 | 2024-01-19 | 111 SE OSCEOLA ST, STUART, FL, 349942114, US | 111 SE OSCEOLA ST STE 201, STUART, FL, 349942114, US | |||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 772-223-2115 |
| Fax | 7722239238 |
Authorized person
| Name | MARC LEVINE |
| Role | MBR |
| Phone | 7722232115 |
Taxonomy
| Taxonomy Code | 163WP0000X - Pain Management Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | No |
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| Is Primary | Yes |
| Taxonomy Code | 2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BS FL |
| Number | 33005 |
| State | FL |
| Issuer | MEDICAID |
| Number | 377066400 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANESTHESIA ASSOCIATES OF FLORIDA 401(K) PLAN | 2023 | 650499574 | 2024-09-12 | MOBILE ANESTHESIA ASSOCIATES, LLC | 9 | |||||||||||||
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| ANESTHESIA ASSOCIATES OF FLORIDA 401(K) PLAN | 2022 | 650499574 | 2023-06-27 | MOBILE ANESTHESIA ASSOCIATES, LLC | 10 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| LEVIN MARC MD | Agent | 3500 SW CENTRE COURT, PALM CITY, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| RUDDY PATRICK | Manager | 115 CAMPBELL DRIVE, WINTER HAVEN, FL, 33884 |
| ALVAREZ RAY | Manager | 111 SE OSCEOLA STREET, SUITE 201, STUART, FL, 34994 |
| LEVINE MARC | Manager | 111 SE OSCEOLA STREET, SUITE 201, STUART, FL, 34994 |
| CHEN EDWARD | Manager | 111 SE OSCEOLA ST SUITE 201, STUART, FL, 34994 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2024-03-08 | No data | No data |
| CONVERSION | 2020-07-06 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS P94000045525. CONVERSION NUMBER 500000204275 |
| Name | Date |
|---|---|
| LC Amendment | 2024-03-08 |
| ANNUAL REPORT | 2024-01-15 |
| ANNUAL REPORT | 2023-01-13 |
| ANNUAL REPORT | 2022-01-06 |
| ANNUAL REPORT | 2021-01-16 |
| Florida Limited Liability | 2020-07-06 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
