| Entity Name: | MARDI GRAS ANESTHESIA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Jan 2024 (a year ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 29 Jan 2024 (a year ago) |
| Document Number: | L24000093522 |
| Address: | 9746 WILSHIRE LAKES BLVD, NAPLES, FL, 34109, US |
| Mail Address: | 9746 WILSHIRE LAKES BLVD, NAPLES, FL, 34109, US |
| ZIP code: | 34109 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538490727 | 2010-01-27 | 2024-08-27 | 9746 WILSHIRE LAKES BLVD, NAPLES, FL, 341090752, US | 13195 METRO PKWY UNIT 12-16, FORT MYERS, FL, 339664810, US | |||||||||||||||||||||
|
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| Phone | +1 239-287-4376 |
| Phone | +1 239-236-2215 |
| Fax | 2392362219 |
Authorized person
| Name | MR. TROY ANTHONY MELANCON |
| Role | PRESIDENT |
| Phone | 2392874376 |
Taxonomy
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| License Number | 9189562 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MELANCON TROY A | Agent | 9746 WILSHIRE LAKES BLVD, NAPLES, FL, 34109 |
| Name | Role | Address |
|---|---|---|
| MELANCON TROY A | Authorized Member | 9746 WILSHIRE LAKES BLVD, NAPLES, FL, 34109 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2024-01-29 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS P04000091306. CONVERSION NUMBER 500000250425 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-01-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
