| Entity Name: | AMSURG MELBOURNE ANESTHESIA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Apr 2015 (10 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 17 May 2017 (8 years ago) |
| Document Number: | M15000002419 |
| FEI/EIN Number | 47-2109888 |
| Address: | 1A BURTON HILLS BLVD, Suite 300, NASHVILLE, TN, 37215, US |
| Mail Address: | 1A BURTON HILLS BLVD, Suite 300, NASHVILLE, TN, 37215, US |
| Place of Formation: | TENNESSEE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477958189 | 2014-10-24 | 2023-01-12 | 1A BURTON HILLS BLVD, ATTN: PROVIDER ENROLLMENT, NASHVILLE, TN, 372156187, US | 1401 S APOLLO BLVD, SUITE B, MELBOURNE, FL, 329013179, US | |||||||||||||||||||
|
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| Phone | +1 615-240-3809 |
| Fax | 6152341809 |
| Phone | +1 321-725-5151 |
| Fax | 3217255157 |
Authorized person
| Name | MRS. JEAN A. KOCHENDORFER |
| Role | SR DIRECTOR OF RCM TRANSFORMATION |
| Phone | 6152634012 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| Reber Paige | Secretary | 1A BURTON HILLS BLVD, NASHVILLE, TN, 37215 |
| Name | Role | Address |
|---|---|---|
| The Melbourne ASC, L.P. | Member | 1A BURTON HILLS BLVD, NASHVILLE, TN, 37215 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-23 | 1A BURTON HILLS BLVD, Suite 300, NASHVILLE, TN 37215 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-23 | 1A BURTON HILLS BLVD, Suite 300, NASHVILLE, TN 37215 | No data |
| LC STMNT OF RA/RO CHG | 2017-05-17 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-05-17 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-05-17 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-04-15 |
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-04 |
| ANNUAL REPORT | 2019-04-16 |
| ANNUAL REPORT | 2018-04-19 |
| CORLCRACHG | 2017-05-17 |
| ANNUAL REPORT | 2017-04-20 |
| ANNUAL REPORT | 2016-03-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
