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  5. DELAND ANESTHESIOLOGY GROUP, INC.

DELAND ANESTHESIOLOGY GROUP, INC.

Company Details

Entity Name: DELAND ANESTHESIOLOGY GROUP, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 16 Feb 2005 (20 years ago)
Date of dissolution: 30 Dec 2024 (a month ago)
Last Event: CORPORATE MERGER
Event Date Filed: 30 Dec 2024 (a month ago)
Document Number: P05000024570
FEI/EIN Number NOT APPLICABLE
Address: 851 Trafalgar Court Suite 200E, Maitland, FL, 32751, US
Mail Address: 851 Trafalgar Court Suite 200E, Maitland, FL, 32751, US
ZIP code: 32751
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1871531293 2006-06-04 2014-10-27 291 SOUTHHALL LN, SUITE 201, MAITLAND, FL, 327517274, US 701 W PLYMOUTH AVE, DELAND, FL, 327203236, US

Contacts
Phone +1 407-667-0444
Fax 4076674338

Authorized person
Name EDMUNDO DELGADO
Role OFFICER OF DELAND ANESTHESIOLOGY
Phone 4076670444

Taxonomy
Taxonomy Code 207L00000X - Anesthesiology Physician
Is Primary Yes
Taxonomy Code 367500000X - Certified Registered Nurse Anesthetist
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 274046000
State FL
Issuer BCBS
Number 94844
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DELAND ANESTHESIOLOGY GROUP 401(K) PROFIT SHARING PLAN 2012 202428069 2013-07-18 DELAND ANESTHESIOLOGY GROUP, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-03-01
Business code 621111
Sponsor’s telephone number 4076670505
Plan sponsor’s address 291 SOUTHHALL LANE SUITE 201, MAITLAND, FL, 32751

Signature of
Role Plan administrator
Date 2013-07-18
Name of individual signing CARL D. MICHAEL
Valid signature Filed with authorized/valid electronic signature
DELAND ANESTHESIOLOGY GROUP 401(K) PROFIT SHARING PLAN 2011 202428069 2012-07-18 DELAND ANESTHESIOLOGY GROUP, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-03-01
Business code 621111
Sponsor’s telephone number 4076670505
Plan sponsor’s address 291 SOUTHHALL LANE SUITE 201, MAITLAND, FL, 32751

Plan administrator’s name and address
Administrator’s EIN 202428069
Plan administrator’s name DELAND ANESTHESIOLOGY GROUP, INC.
Plan administrator’s address 291 SOUTHHALL LANE SUITE 201, MAITLAND, FL, 32751
Administrator’s telephone number 4076670505

Signature of
Role Plan administrator
Date 2012-07-18
Name of individual signing CARL D. MICHAEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-18
Name of individual signing CARL D. MICHAEL
Valid signature Filed with authorized/valid electronic signature
DELAND ANESTHESIOLOGY GROUP 401(K) PROFIT SHARING PLAN 2010 202428069 2011-07-25 DELAND ANESTHESIOLOGY GROUP, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-03-01
Business code 621111
Sponsor’s telephone number 4076670505
Plan sponsor’s address 291 SOUTHHALL LANE, SUITE 201, MAITLAND, FL, 32751

Plan administrator’s name and address
Administrator’s EIN 202428069
Plan administrator’s name DELAND ANESTHESIOLOGY GROUP, INC.
Plan administrator’s address 291 SOUTHHALL LANE, SUITE 201, MAITLAND, FL, 32751
Administrator’s telephone number 4076670505

Signature of
Role Plan administrator
Date 2011-07-25
Name of individual signing CARL MICHAEL
Valid signature Filed with authorized/valid electronic signature
DELAND ANESTHESIOLOGY GROUP 401(K) PROFIT SHARING PLAN 2009 202428069 2010-09-17 DELAND ANESTHESIOLOGY GROUP, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-03-01
Business code 621111
Sponsor’s telephone number 4076670505
Plan sponsor’s address 291 SOUTHHALL LANE, SUITE 201, MAITLAND, FL, 32751

Plan administrator’s name and address
Administrator’s EIN 202428069
Plan administrator’s name DELAND ANESTHESIOLOGY GROUP, INC.
Plan administrator’s address 291 SOUTHHALL LANE, SUITE 201, MAITLAND, FL, 32751
Administrator’s telephone number 4076670505

Signature of
Role Plan administrator
Date 2010-09-17
Name of individual signing CARL MICHAEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-17
Name of individual signing CARL MICHAEL
Valid signature Filed with authorized/valid electronic signature
DELAND ANESTHESIOLOGY GROUP 401(K) PROFIT SHARING PLAN 2009 202428069 2010-08-03 DELAND ANESTHESIOLOGY GROUP, INC. 7
Three-digit plan number (PN) 001
Effective date of plan 2005-03-01
Business code 621111
Sponsor’s telephone number 4076670505
Plan sponsor’s address 291 SOUTHHALL LANE, SUITE 201, MAITLAND, FL, 32751

Plan administrator’s name and address
Administrator’s EIN 202428069
Plan administrator’s name DELAND ANESTHESIOLOGY GROUP, INC.
Plan administrator’s address 291 SOUTHHALL LANE, SUITE 201, MAITLAND, FL, 32751
Administrator’s telephone number 4076670505

Signature of
Role Plan administrator
Date 2010-08-03
Name of individual signing CARL MICHAEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-03
Name of individual signing CARL MICHAEL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
CORPORATION SERVICE COMPANY Agent

President

Name Role Address
WRIGHT LEN President 851 Trafalgar Court Suite 200E, Maitland, FL, 32751

Treasurer

Name Role Address
MCBEE TYLER Treasurer 851 Trafalgar Court Suite 200E, Maitland, FL, 32751

Secretary

Name Role Address
SANFORD AMY Secretary 851 Trafalgar Court Suite 200E, Maitland, FL, 32751

Events

Event Type Filed Date Value Description
MERGER 2024-12-30 No data CORPORATION WAS PART OF A MERGER. QUALIFIED CORPORATION WAS P05000061185. MERGER NUMBER 900000263069
CHANGE OF PRINCIPAL ADDRESS 2021-05-19 851 Trafalgar Court Suite 200E, Maitland, FL 32751 No data
CHANGE OF MAILING ADDRESS 2021-05-19 851 Trafalgar Court Suite 200E, Maitland, FL 32751 No data
AMENDED AND RESTATEDARTICLES 2013-12-31 No data No data
REGISTERED AGENT NAME CHANGED 2013-12-31 CORPORATION SERVICE COMPANY No data
REGISTERED AGENT ADDRESS CHANGED 2013-12-31 1201 HAYS STREET, TALLAHASSEE, FL 32301 No data

Documents

Name Date
ANNUAL REPORT 2024-02-01
ANNUAL REPORT 2023-02-24
AMENDED ANNUAL REPORT 2022-06-17
ANNUAL REPORT 2022-03-30
ANNUAL REPORT 2021-05-19
ANNUAL REPORT 2020-02-01
ANNUAL REPORT 2019-02-28
ANNUAL REPORT 2018-04-17
AMENDED ANNUAL REPORT 2017-06-20
ANNUAL REPORT 2017-01-11

Related by officers

WRIGHT LEN

JLR RESEARCH, INC. ANESTHESIA ONCALL, INC. JLR HEALTHCARE SOLUTIONS, INC. MEDICAL ANESTHESIA AND PAIN MANAGEMENT CONSULTANTS, INC. JLR HOLDING COMPANY JACKSONVILLE ANESTHESIA CORPORATION, INC. U.S. ANESTHESIA PARTNERS OF FLORIDA, INC. FLORIDA ANESTHESIA ASSOCIATES, INC.

MCBEE TYLER

JLR RESEARCH, INC. JLR HEALTHCARE SOLUTIONS, INC. MEDICAL ANESTHESIA AND PAIN MANAGEMENT CONSULTANTS, INC. JLR HOLDING COMPANY JACKSONVILLE ANESTHESIA CORPORATION, INC. U.S. ANESTHESIA PARTNERS OF FLORIDA, INC. FLORIDA ANESTHESIA ASSOCIATES, INC.

SANFORD AMY

WATERMAN ANESTHESIOLOGY GROUP, INC. JLR RESEARCH, INC. USAP OF FLORIDA, INC. ANESTHESIA ONCALL, INC. YESPLEASEFREEZE LLC JLR HEALTHCARE SOLUTIONS, INC. MEDICAL ANESTHESIA AND PAIN MANAGEMENT CONSULTANTS, INC. JLR HOLDING COMPANY JACKSONVILLE ANESTHESIA CORPORATION, INC. U.S. ANESTHESIA PARTNERS OF FLORIDA, INC.

Related by address

851 Trafalgar Court Suite 200E, Maitland, FL, 32751, US

MEDICAL ANESTHESIA AND PAIN MANAGEMENT CONSULTANTS, INC. JACKSONVILLE ANESTHESIA CORPORATION, INC. FLORIDA ANESTHESIA ASSOCIATES, INC.

851 Trafalgar Court Suite 200E, Maitland, FL, 32751, US

MEDICAL ANESTHESIA AND PAIN MANAGEMENT CONSULTANTS, INC. JACKSONVILLE ANESTHESIA CORPORATION, INC. FLORIDA ANESTHESIA ASSOCIATES, INC.

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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