| Entity Name: | KEY WEST ANESTHESIA SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 May 2018 (7 years ago) |
| Document Number: | M18000005256 |
| FEI/EIN Number | 371881564 |
| Address: | 3102 ERICA, SEDALIA, MO, 65301, US |
| Mail Address: | PO BOX 1612, SEDALIA, MO, 65302, US |
| Place of Formation: | MISSOURI |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598269524 | 2018-03-23 | 2020-02-21 | PO BOX 1547, SEDALIA, MO, 653021547, US | 5900 COLLEGE RD, KEY WEST, FL, 330404342, US | |||||||||||||||||||||||||
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| Phone | +1 660-826-5960 |
| Fax | 6608264852 |
Authorized person
| Name | ROBERT CLEMENS |
| Role | CEO |
| Phone | 6608265960 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 024919700 |
| State | FL |
| Name | Role |
|---|---|
| REGISTERED AGENTS INC | Agent |
| Name | Role | Address |
|---|---|---|
| CLEMENS ROB | Officer | 3102 ERICA, SEDALIA, MO, 65301 |
| Name | Role | Address |
|---|---|---|
| CROUCH MICHAEL | ACCO | 3102 ERICA, SEDALIA, MO, 65301 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-25 | 7901 4TH STREET NORTH, SUITE 300, ST.PETERSBURG, FL 33702 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-23 |
| ANNUAL REPORT | 2023-02-09 |
| ANNUAL REPORT | 2022-01-18 |
| ANNUAL REPORT | 2021-02-19 |
| ANNUAL REPORT | 2020-03-17 |
| ANNUAL REPORT | 2019-03-12 |
| Foreign Limited | 2018-05-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
