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LAKESIDE ANESTHESIA GROUP, LLC - Florida Company Profile

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Company Details

Entity Name: LAKESIDE ANESTHESIA GROUP, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 02 Apr 2024 (a year ago)
Document Number: L24000152702
FEI/EIN Number 992366684
Address: 3030 HARTLEY RD STE 310, JACKSONVILLE, FL, 32257-8213, US
Mail Address: 3030 HARTLEY RD STE 310, JACKSONVILLE, FL, 32257-8213, US
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
WEAVER ANDREW Agent 3030 HARTLEY RD STE 310, JACKSONVILLE, FL, 322578213
WEAVER ROBERT VDR. Officer 3030 HARTLEY RD STE 310, JACKSONVILLE, FL, 322578213
WEAVER J. PATRICK Dr. Officer 3030 HARTLEY RD STE 310, JACKSONVILLE, FL, 322578213
WEAVER ANDREW C President 3030 HARTLEY RD STE 310, JACKSONVILLE, FL, 322578213

National Provider Identifier

NPI Number:
1043063068
Certification Date:
2024-04-24

Authorized Person:

Name:
MR. ANDREW WEAVER
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
Yes

Contacts:

Fax:
9043061351

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-07-30 3030 Hartley Rd., Ste. 310, JACKSONVILLE, FL 32257 -
CHANGE OF MAILING ADDRESS 2024-07-30 3030 Hartley Rd., Ste. 310, JACKSONVILLE, FL 32257 -

Documents

Name Date
Florida Limited Liability 2024-04-02

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Date of last update: 01 Aug 2025

Sources: Florida Department of State