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PALM BAY ANESTHESIA, INC. - Florida Company Profile

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Company Details

Entity Name: PALM BAY ANESTHESIA, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 28 Aug 2003 (22 years ago)
Date of dissolution: 27 Sep 2013 (12 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2013 (12 years ago)
Document Number: P03000094815
FEI/EIN Number 810629991
Address: 1425 MALABAR ROAD N.E., PALM BAY, FL, 32907
Mail Address: 1425 MALABAR ROAD N.E., PALM BAY, FL, 32907
ZIP code: 32907
City: Palm Bay
County: Brevard
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
HARPER STEVEN Vice President 1425 MALABAR ROAD N.E., PALM BAY, FL, 32907
MURTHA PATRICK A Director 1425 MALABAR ROAD N.E., PALM BAY, FL, 32907
MURTHA PATRICK A Secretary 1425 MALABAR ROAD N.E., PALM BAY, FL, 32907
BLACKWOOD ROBERT S Treasurer 1425 MALABAR ROAD N.E., PALM BAY, FL, 32907
COLEMAN CHRISTOPHER J Agent 1329 BEDFORD DRIVE, MELBOURNE, FL, 32940
BLACKWOOD ROBERT S Director 1425 MALABAR ROAD N.E., PALM BAY, FL, 32907
VANDENBOSCH MARK J Director 1425 MALABAR ROAD N.E., PALM BAY, FL, 32907
VANDENBOSCH MARK J President 1425 MALABAR ROAD N.E., PALM BAY, FL, 32907
HARPER STEVEN Director 1425 MALABAR ROAD N.E., PALM BAY, FL, 32907

National Provider Identifier

NPI Number:
1780617738

Authorized Person:

Name:
MARK VANDENBOSCH
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
3217844090

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2013-09-27 - -

Documents

Name Date
ANNUAL REPORT 2012-01-09
ANNUAL REPORT 2011-04-04
ANNUAL REPORT 2010-02-26
ANNUAL REPORT 2009-04-27
ANNUAL REPORT 2008-01-09
ANNUAL REPORT 2007-02-08
ANNUAL REPORT 2006-04-04
ANNUAL REPORT 2005-07-01
ANNUAL REPORT 2004-04-06
Domestic Profit 2003-08-29

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Date of last update: 02 Aug 2025

Sources: Florida Department of State