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RIVERCOAST ANESTHESIA, P.A. - Florida Company Profile

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Company Details

Entity Name: RIVERCOAST ANESTHESIA, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 13 Aug 2013 (12 years ago)
Document Number: P13000067399
FEI/EIN Number 46-3554647
Address: 1899 Murrell Road, Rockledge, FL, 32955, US
Mail Address: 1965 Rockledge Dr, Rockledge, FL, 32955, US
ZIP code: 32955
City: Rockledge
County: Brevard
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
WILLIS MICHAEL President 1965 ROCKLEDGE DRIVE, ROCKLEDGE, FL, 32955
Willis Kevin Manager 1899 Murrell Road, Rockledge, FL, 32955
WIllis Michael D Agent 1965 Rockledge Drive, Rockledge, FL, 32955

National Provider Identifier

NPI Number:
1609252188

Authorized Person:

Name:
DR. MICHAEL DELANO WILLIS
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QP3300X - Pain Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
3213382977

Form 5500 Series

Employer Identification Number (EIN):
463554647
Plan Year:
2023
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
4
Sponsors Telephone Number:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000050658 RIVERCOAST PAIN MANAGEMENT EXPIRED 2014-05-23 2019-12-31 - 1965 ROCKLEDGE DRIVE, ROCKLEDGE, FL, 32955

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-03-18 1899 Murrell Road, Suite #130, Rockledge, FL 32955 -
CHANGE OF MAILING ADDRESS 2024-03-18 1899 Murrell Road, Suite #130, Rockledge, FL 32955 -
REGISTERED AGENT NAME CHANGED 2014-03-17 WIllis, Michael D -
REGISTERED AGENT ADDRESS CHANGED 2014-03-17 1965 Rockledge Drive, Rockledge, FL 32955 -

Documents

Name Date
ANNUAL REPORT 2024-03-18
ANNUAL REPORT 2023-04-14
ANNUAL REPORT 2022-03-17
ANNUAL REPORT 2021-02-05
ANNUAL REPORT 2020-03-25
ANNUAL REPORT 2019-02-13
ANNUAL REPORT 2018-03-11
ANNUAL REPORT 2017-02-19
ANNUAL REPORT 2016-03-06
ANNUAL REPORT 2015-04-22

USAspending Awards / Financial Assistance

Date:
2020-04-29
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
959.59
Total Face Value Of Loan:
93259.59
Date:
2020-04-09
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
92300.00
Total Face Value Of Loan:
93259.59

Paycheck Protection Program

Jobs Reported:
7
Initial Approval Amount:
$92,300
Date Approved:
2020-04-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$93,259.59
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$94,091.15
Servicing Lender:
Truist Bank
Use of Proceeds:
Payroll: $93,259.59

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Date of last update: 03 Aug 2025

Sources: Florida Department of State