| Entity Name: | ALL SAINTS ANESTHESIA & PAIN MANAGEMENT, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 29 Aug 2003 (21 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | P03000096622 |
| FEI/EIN Number | 571188316 |
| Mail Address: | 11377 CORTEZ BLVD, BROOKSVILLE, FL, 34613 |
| Address: | 11377 CORTEZ BLVD., BROOKSVILLE, FL, 34613 |
| ZIP code: | 34613 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447248414 | 2005-10-12 | 2020-08-22 | 11377 CORTEZ BLVD, BROOKSVILLE, FL, 346135409, US | 11377 CORTEZ BLVD, BROOKSVILLE, FL, 346135409, US | |||||||||||||||||||||||||
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| Phone | +1 352-597-3060 |
| Fax | 3525973077 |
Authorized person
| Name | MR. MICHAEL A. GUARINO |
| Role | ADMINISTRATOR |
| Phone | 3525973060 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | HCC5566 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0570885000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ALL SAINTS SURGERY CENTER, INC | Agent | 11377 CORTEZ BLVD, BROOKSVILLE, FL, 34613 |
| Name | Role | Address |
|---|---|---|
| JACHIMOWICA JAMES M | President | 14543 CORTEZ BLVD., #202, BROOKSVILLE, FL, 34613 |
| Name | Role | Address |
|---|---|---|
| FLATAU ARTHUR I | Director | 11373 CORTEZ BLVD., #202, BROOKSVILLE, FL, 34613 |
| CACIOPPO LEONARD M | Director | 14543 CORTEZ BLVD., BROOKSVILLE, FL, 34613 |
| Name | Role | Address |
|---|---|---|
| SZYDLOWSKI WALTER M | Treasurer | 11373 CORTEZ BLVD., BROOKSVILLE, FL, 34613 |
| Name | Role | Address |
|---|---|---|
| WARD THOMAS D | Secretary | 11373 CORTEZ BLVD., #400, BROOKSVILLE, FL, 34613 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CANCEL ADM DISS/REV | 2007-03-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| NAME CHANGE AMENDMENT | 2005-04-01 | ALL SAINTS ANESTHESIA & PAIN MANAGEMENT, P.A. | No data |
| CHANGE OF MAILING ADDRESS | 2005-04-01 | 11377 CORTEZ BLVD., BROOKSVILLE, FL 34613 | No data |
| REGISTERED AGENT NAME CHANGED | 2005-04-01 | ALL SAINTS SURGERY CENTER, INC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-04-01 | 11377 CORTEZ BLVD, BROOKSVILLE, FL 34613 | No data |
| AMENDMENT AND NAME CHANGE | 2004-04-23 | ALL SAINTS ANESTHESIA, P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-04-10 |
| REINSTATEMENT | 2007-03-05 |
| ANNUAL REPORT | 2005-04-01 |
| Name Change | 2005-04-01 |
| Amendment and Name Change | 2004-04-23 |
| ANNUAL REPORT | 2004-02-12 |
| Domestic Profit | 2003-08-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
