| Entity Name: | BAYSHORE ANESTHESIA, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
BAYSHORE ANESTHESIA, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 26 Apr 2000 (25 years ago) |
| Date of dissolution: | 25 Sep 2015 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (10 years ago) |
| Document Number: | P00000042033 |
| FEI/EIN Number |
593642299
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 2190 HIGHWAY 85 N, NICEVILLE, FL, 32578 |
| Mail Address: | 1013 CROOKED CREEK COVE, NICEVILLE, FL, 32578 |
| ZIP code: | 32578 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659477461 | 2006-09-16 | 2011-08-09 | PO BOX 7419, ORLANDO, FL, 328917419, US | 2190 HIGHWAY 85 N, NICEVILLE, FL, 325781045, US | |||||||||||||||||||||||||||||||
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| Phone | +1 352-867-8898 |
| Fax | 3527326282 |
Authorized person
| Name | DR. ARTHUR PAUL BROADERICK |
| Role | MD/PRESIDENT |
| Phone | 3528678898 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| License Number | ME69348 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 28253 |
| State | FL |
| Issuer | MEDICAID |
| Number | 379870400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BROADERICK ARTHUR P | Director | 1013 CROOKED CREEK COVE, NICEVILLE, FL, 32578 |
| BROADERICK KATHLEEN E | Manager | 1013 CROOKED CREEK COVE, NICEVILLE, FL, 32578 |
| BROADERICK ARTHUR P | Agent | 1013 CROOKED CREEK, NICEVILLE, FL, 32578 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | - | - |
| CHANGE OF MAILING ADDRESS | 2011-04-07 | 2190 HIGHWAY 85 N, NICEVILLE, FL 32578 | - |
| REGISTERED AGENT NAME CHANGED | 2011-04-07 | BROADERICK, ARTHUR P | - |
| REGISTERED AGENT ADDRESS CHANGED | 2009-07-17 | 1013 CROOKED CREEK, NICEVILLE, FL 32578 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2008-05-27 | 2190 HIGHWAY 85 N, NICEVILLE, FL 32578 | - |
| CANCEL ADM DISS/REV | 2006-02-03 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-04-19 |
| ANNUAL REPORT | 2013-04-30 |
| ANNUAL REPORT | 2012-05-04 |
| ANNUAL REPORT | 2011-04-07 |
| ANNUAL REPORT | 2010-03-03 |
| ANNUAL REPORT | 2009-07-17 |
| ANNUAL REPORT | 2008-05-27 |
| ANNUAL REPORT | 2007-02-02 |
| REINSTATEMENT | 2006-02-03 |
| ANNUAL REPORT | 2004-09-15 |
Date of last update: 02 May 2025
Sources: Florida Department of State
