| Entity Name: | FLORIDA GULF COAST ANESTHESIA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 25 Aug 2020 (4 years ago) |
| Document Number: | L20000251966 |
| FEI/EIN Number | 85-2725151 |
| Address: | 100 MIDDLE PLANTATION CIRCLE, GULF BREEZE, FL 32561 |
| Mail Address: | 100 MIDDLE PLANTATION CIRCLE, GULF BREEZE, FL 32561 |
| ZIP code: | 32561 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013522325 | 2020-09-14 | 2020-11-04 | 3104 BLUE LAKE DR STE 110, VESTAVIA, AL, 352432372, US | 4724 N DAVIS HWY, PENSACOLA, FL, 325032339, US | |||||||||||||||||
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| Phone | +1 205-977-1949 |
| Fax | 3343774417 |
| Phone | +1 850-696-4000 |
Authorized person
| Name | KIM TRAN |
| Role | MANAGER |
| Phone | 8189708191 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RUSHING, ROBERT S | Agent | 151 WEST MAIN STREET, SUITE 200, PENSACOLA, FL 32502 |
| Name | Role | Address |
|---|---|---|
| SULLIVAN, BRETT | Manager | 100 MIDDLE PLANTATION CIRCLE, GULF BREEZE, FL 32561 |
| TRAN, KIM | Manager | 2650 WHALEY AVENUE, PENSACOLA, FL 32503 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-02 |
| ANNUAL REPORT | 2023-03-08 |
| ANNUAL REPORT | 2022-04-07 |
| ANNUAL REPORT | 2021-03-10 |
| Florida Limited Liability | 2020-08-25 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
