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  5. WHITE SANDS ANESTHESIA & PAIN MEDICINE, INC.

WHITE SANDS ANESTHESIA & PAIN MEDICINE, INC.

Company Details

Entity Name: WHITE SANDS ANESTHESIA & PAIN MEDICINE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 14 Dec 2004 (20 years ago)
Date of dissolution: 03 Jan 2022 (3 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 03 Jan 2022 (3 years ago)
Document Number: P04000167826
FEI/EIN Number 202214491
Address: 2338 STATE AVENUE, PANAMA CITY, FL, 32405
Mail Address: P.O. BOX 1968, PANAMA CITY, FL, 32402
ZIP code: 32405
County: Bay
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1730100488 2006-07-21 2012-12-05 PO BOX 1968, PANAMA CITY, FL, 324021968, US 2338 STATE AVE, PANAMA CITY, FL, 324054361, US

Contacts
Phone +1 850-872-0303
Fax 8508720305

Authorized person
Name DR. KEITH M ZWINGELBERG
Role PRESIDENT
Phone 8508720303

Taxonomy
Taxonomy Code 207LP2900X - Pain Medicine (Anesthesiology) Physician
License Number ME36522
State FL
Is Primary Yes

Other Provider Identifiers
Issuer BCBS FL
Number 03579A
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WHITE SANDS ANESTHESIA & PAIN MEDICINE INC CASH BALANCE 2018 202214491 2019-10-09 WHITE SANDS ANESTHESIA & PAIN MEDICINE INC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8508720303
Plan sponsor’s address P O BOX 1968, PANAMA CITY, FL, 32402
WHITE SANDS ANESTHESIA & PAIN MEDICINE INC CASH BALANCE 2017 202214491 2019-02-19 WHITE SANDS ANESTHESIA & PAIN MEDICINE INC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8508720303
Plan sponsor’s address P O BOX 1968, PANAMA CITY, FL, 32402
WHITE SANDS ANESTHESIA & PAIN MEDICINE INC CASH BALANCE 2016 202214491 2017-10-11 WHITE SANDS ANESTHESIA & PAIN MEDICINE INC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8508720303
Plan sponsor’s address P O BOX 1968, PANAMA CITY, FL, 32402
WHITE SANDS ANESTHESIA & PAIN MEDICINE INC CASH BALANCE 2015 202214491 2016-10-07 WHITE SANDS ANESTHESIA & PAIN MEDICINE INC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8508720303
Plan sponsor’s address P O BOX 1968, PANAMA CITY, FL, 32402
WHITE SANDS ANESTHESIA & PAIN MEDICINE INC CASH BALANCE 2014 202214491 2015-04-23 WHITE SANDS ANESTHESIA & PAIN MEDICINE INC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8508720303
Plan sponsor’s address P O BOX 1968, PANAMA CITY, FL, 32402
WHITE SANDS ANESTHESIA & PAIN MEDICINE INC CASH BALANCE 2013 202214491 2014-07-28 WHITE SANDS ANESTHESIA & PAIN MEDICINE INC 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8508720303
Plan sponsor’s address P O BOX 1968, PANAMA CITY, FL, 32402

Agent

Name Role Address
Bancroft Cassidy H Agent 2338 STATE AVE, PANAMA CITY, FL, 32405

President

Name Role Address
ZWINGELBERG KEITH M President 2338 STATE AVENUE, PANAMA CITY, FL, 32405

Vice President

Name Role Address
ZWINGELBERG KEITH M Vice President 2338 STATE AVENUE, PANAMA CITY, FL, 32405

Secretary

Name Role Address
ZWINGELBERG KEITH M Secretary 2338 STATE AVENUE, PANAMA CITY, FL, 32405

Treasurer

Name Role Address
ZWINGELBERG KEITH M Treasurer 2338 STATE AVENUE, PANAMA CITY, FL, 32405

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2022-01-03 No data No data
REGISTERED AGENT NAME CHANGED 2013-04-30 Bancroft, Cassidy H No data
REINSTATEMENT 2012-11-09 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2012-09-28 No data No data
REGISTERED AGENT ADDRESS CHANGED 2008-04-30 2338 STATE AVE, PANAMA CITY, FL 32405 No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2022-01-03
ANNUAL REPORT 2021-01-28
ANNUAL REPORT 2020-06-25
ANNUAL REPORT 2019-02-07
ANNUAL REPORT 2018-02-08
ANNUAL REPORT 2017-02-28
ANNUAL REPORT 2016-03-09
ANNUAL REPORT 2015-01-22
ANNUAL REPORT 2014-03-26
ANNUAL REPORT 2013-04-30

Related by officers

ZWINGELBERG KEITH M

WHITE SANDS ANESTHESIA & PAIN MEDICINE, L.L.C. ZWESH REALTY, INC.

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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