| Entity Name: | NATURE COAST ANESTHESIA PROVIDERS, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 05 Jun 2000 (25 years ago) |
| Date of dissolution: | 19 Nov 2024 (3 months ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 19 Nov 2024 (3 months ago) |
| Document Number: | P00000054166 |
| FEI/EIN Number | 593646481 |
| Address: | 421 SE Alfred Markham Street, Lake City, FL, 32025, US |
| Mail Address: | 421 SE Alfred Markham Street, Lake City, FL, 32025, US |
| ZIP code: | 32025 |
| County: | Columbia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578557104 | 2005-09-09 | 2022-05-09 | 421 SE ALFRED MARKHAM ST., LAKE CITY, FL, 32025, US | 17560 US HIGHWAY 441, MOUNT DORA, FL, 327576711, US | |||||||||||||||||||||||||||
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| Phone | +1 386-697-1364 |
| Fax | 8883703379 |
Authorized person
| Name | WILLIAM S JONES |
| Role | OWNER |
| Phone | 3866971364 |
Taxonomy
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 305017300 |
| State | FL |
| Issuer | BLUE SHIELD |
| Number | 99878 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JONES WILLIAM | Agent | 1850 NE 128TH PLACE, BRANFORD, FL, 32008 |
| Name | Role | Address |
|---|---|---|
| JONES WILLIAM | Director | 1850 NE 128TH PLACE, BRANFORD, FL, 32008 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2024-11-19 | No data | CONVERSION MEMBER. RESULTING CORPORATION WAS L24000489201. CONVERSION NUMBER 900000260869 |
| CHANGE OF MAILING ADDRESS | 2014-02-25 | 421 SE Alfred Markham Street, Lake City, FL 32025 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-01-23 | 421 SE Alfred Markham Street, Lake City, FL 32025 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-03-02 | 1850 NE 128TH PLACE, BRANFORD, FL 32008 | No data |
| REGISTERED AGENT NAME CHANGED | 2004-01-26 | JONES, WILLIAM | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-16 |
| ANNUAL REPORT | 2023-04-07 |
| ANNUAL REPORT | 2022-02-21 |
| ANNUAL REPORT | 2021-03-19 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-02-09 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-01-23 |
| ANNUAL REPORT | 2016-01-26 |
| ANNUAL REPORT | 2015-04-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
