| Entity Name: | PORT ST LUCIE ANESTHESIA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Nov 2017 (7 years ago) |
| Document Number: | M17000010584 |
| FEI/EIN Number | 82-3550193 |
| 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 | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215441134 | 2017-11-30 | 2023-01-20 | 1A BURTON HILLS BLVD, NASHVILLE, TN, 372156187, US | 1715 SE TIFFANY AVE, PORT ST LUCIE, FL, 349527511, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 615-922-6102 |
| Phone | +1 772-335-7005 |
Authorized person
| Name | JEAN KOCHENDORFER |
| Role | SR DIRECTOR OF RCM TRANSFORMATION |
| Phone | 6152403795 |
Taxonomy
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| Reber Paige | Secretary | 1A BURTON HILLS BLVD, NASHVILLE, TN, 37215 |
| Name | Role |
|---|---|
| AMSURG HOLDINGS, LLC | Member |
| 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 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-28 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-27 |
| Foreign Limited | 2017-11-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
