| Entity Name: | PINELLAS COUNTY ANESTHESIA ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 May 2021 (4 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 19 Sep 2022 (2 years ago) |
| Document Number: | L21000249735 |
| FEI/EIN Number | 87-0962933 |
| 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 | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104592476 | 2021-08-18 | 2023-07-05 | PO BOX 730996, DALLAS, TX, 753730996, US | 616 E ST STE A, CLEARWATER, FL, 337563342, US | |||||||||||||||||||||
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| Phone | +1 888-851-4642 |
| Fax | 8666658561 |
| Phone | +1 727-447-0888 |
Authorized person
| Name | JEFF PERRY |
| Role | MANAGER |
| Phone | 5024184700 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | No |
| Name | Role |
|---|---|
| BLALOCK WALTERS, P.A. | Agent |
| 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 |
|---|---|---|---|
| LC AMENDMENT | 2022-09-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-02-01 |
| LC Amendment | 2022-09-19 |
| ANNUAL REPORT | 2022-02-24 |
| Florida Limited Liability | 2021-05-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
