Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Lake
    4. ›
  4. 34711
    5. ›
  5. SOUTH LAKE ANESTHESIA SERVICES, P.A.

SOUTH LAKE ANESTHESIA SERVICES, P.A. - Florida Company Profile

Company Details

Entity Name: SOUTH LAKE ANESTHESIA SERVICES, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

SOUTH LAKE ANESTHESIA SERVICES, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 22 Dec 1999 (25 years ago)
Date of dissolution: 06 Dec 2016 (8 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 06 Dec 2016 (8 years ago)
Document Number: P99000111399
FEI/EIN Number 593613830

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 1381 CITRUS TOWER BLVD., STE. 4, CLERMONT, FL, 34711, US
Mail Address: 1381 CITRUS TOWER BLVD., STE. 4, CLERMONT, FL, 34711, US
ZIP code: 34711
County: Lake
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1750710778 2013-11-12 2013-11-12 1381 CITRUS TOWER BLVD, SUITE 4, CLERMONT, FL, 347111957, US 1099 CITRUS TOWER BLVD, CLERMONT, FL, 347111947, US

Contacts
Phone +1 352-243-9114
Fax 3522437822
Phone +1 352-394-4071

Authorized person
Name BRIAN CONNOR
Role ADMINISTRATOR
Phone 3522439114

Taxonomy
Taxonomy Code 367500000X - Certified Registered Nurse Anesthetist
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
401K PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF SOUTH LAKE ANESTHESIA SERVICES, P.A. 2016 593613830 2017-10-16 SOUTH LAKE ANESTHESIA SERVICES, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1381 CITRUS TOWER BLVD., SUITE 4, CLERMONT, FL, 34711
401K PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF SOUTH LAKE ANESTHESIA SERVICES, P.A. 2015 593613830 2016-09-30 SOUTH LAKE ANESTHESIA SERVICES, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1381 CITRUS TOWER BLVD., SUITE 4, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2016-09-30
Name of individual signing D. SCOT GHIVIZZANI, M.D.
Valid signature Filed with authorized/valid electronic signature
401K PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF SOUTH LAKE ANESTHESIA SERVICES, P.A. 2014 593613830 2015-09-28 SOUTH LAKE ANESTHESIA SERVICES, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1381 CITRUS TOWER BLVD., SUITE 4, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2015-09-28
Name of individual signing D. SCOT GHIVIZZANI, M.D.
Valid signature Filed with authorized/valid electronic signature
401K PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF SOUTH LAKE ANESTHESIA SERVICES, P.A. 2013 593613830 2014-09-22 SOUTH LAKE ANESTHESIA SERVICES, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1381 CITRUS TOWER BLVD., SUITE 4, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2014-09-22
Name of individual signing D. SCOT GHIVIZZANI, M.D.
Valid signature Filed with authorized/valid electronic signature
401K PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF SOUTH LAKE ANESTHESIA SERVICES, P.A. 2012 593613830 2013-10-14 SOUTH LAKE ANESTHESIA SERVICES, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1381 CITRUS TOWER BLVD., SUITE 4, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing D. SCOT GHIVIZZANI, M.D.
Valid signature Filed with authorized/valid electronic signature
401K PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF SOUTH LAKE ANESTHESIA SERVICES, P.A. 2011 593613830 2012-10-12 SOUTH LAKE ANESTHESIA SERVICES, P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1381 CITRUS TOWER BLVD., SUITE 4, CLERMONT, FL, 34711

Plan administrator’s name and address
Administrator’s EIN 593613830
Plan administrator’s name SOUTH LAKE ANESTHESIA SERVICES, P.A.
Plan administrator’s address 1381 CITRUS TOWER BLVD., SUITE 4, CLERMONT, FL, 34711
Administrator’s telephone number 4075995900

Signature of
Role Plan administrator
Date 2012-10-12
Name of individual signing D. SCOT GHIVIZZANI, M.D.
Valid signature Filed with authorized/valid electronic signature
401K PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF SOUTH LAKE ANESTHESIA SERVICES, P.A. 2010 593613830 2011-10-04 SOUTH LAKE ANESTHESIA SERVICES, P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1381 CITRUS TOWER BLVD., SUITE 4, CLERMONT, FL, 34711

Plan administrator’s name and address
Administrator’s EIN 593613830
Plan administrator’s name SOUTH LAKE ANESTHESIA SERVICES, P.A.
Plan administrator’s address 1381 CITRUS TOWER BLVD., SUITE 4, CLERMONT, FL, 34711
Administrator’s telephone number 4075995900

Signature of
Role Plan administrator
Date 2011-10-04
Name of individual signing D. SCOT GHIVIZZANI, M.D.
Valid signature Filed with authorized/valid electronic signature
401K PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF SOUTH LAKE ANESTHESIA SERVICES, P.A. 2009 593613830 2010-10-11 SOUTH LAKE ANESTHESIA SERVICES, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1381 CITRUS TOWER BLVD., SUITE 4, CLERMONT, FL, 34711

Plan administrator’s name and address
Administrator’s EIN 593613830
Plan administrator’s name SOUTH LAKE ANESTHESIA SERVICES, P.A.
Plan administrator’s address 1381 CITRUS TOWER BLVD., SUITE 4, CLERMONT, FL, 34711
Administrator’s telephone number 4075995900

Signature of
Role Plan administrator
Date 2010-10-11
Name of individual signing D. SCOT GHIVIZZANI, M.D.
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
GHIVIZZANI DAVID S President 17137 MAGNOLIA ISLAND BLVD, CLERMONT, FL, 34711
HOLLAND JULIE H Director 11246 BRIDGE HOUSE ROAD, WINDERMERE, FL, 34786
HOLLAND JULIE H Vice President 11246 BRIDGE HOUSE ROAD, WINDERMERE, FL, 34786
HOLLAND JULIE H Secretary 11246 BRIDGE HOUSE ROAD, WINDERMERE, FL, 34786
GHIVIZZANI DAVID S Agent 1381 CITRUS TOWER BLVD., STE. 4, CLERMONT, FL, 34711
GHIVIZZANI DAVID S Director 17137 MAGNOLIA ISLAND BLVD, CLERMONT, FL, 34711
GHIVIZZANI DAVID S Treasurer 17137 MAGNOLIA ISLAND BLVD, CLERMONT, FL, 34711

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2016-12-06 - -
CHANGE OF PRINCIPAL ADDRESS 2006-11-20 1381 CITRUS TOWER BLVD., STE. 4, CLERMONT, FL 34711 -
CHANGE OF MAILING ADDRESS 2006-11-20 1381 CITRUS TOWER BLVD., STE. 4, CLERMONT, FL 34711 -
REGISTERED AGENT ADDRESS CHANGED 2006-11-20 1381 CITRUS TOWER BLVD., STE. 4, CLERMONT, FL 34711 -

Documents

Name Date
ANNUAL REPORT 2016-01-19
ANNUAL REPORT 2015-01-21
ANNUAL REPORT 2014-01-13
ANNUAL REPORT 2013-01-28
ANNUAL REPORT 2012-01-26
ANNUAL REPORT 2011-01-04
ANNUAL REPORT 2010-01-13
ANNUAL REPORT 2009-01-12
ANNUAL REPORT 2008-01-03
ANNUAL REPORT 2007-01-16

Companies related by officers

GHIVIZZANI DAVID S

QUESTIONS OF SCIENCE, INC. - Inactive
Domestic Profit (2021 - 2022)
ANESTHESIA BILLING SPECIALISTS OF FLORIDA INC. - Inactive
Domestic Profit (2009 - 2016)
ANESTHESIA BILLING SPECIALISTS OF FLORIDA INC. - Inactive
Domestic Profit (2009 - 2016)
ANESTHESIA BILLING SPECIALISTS OF FLORIDA INC. - Inactive
Domestic Profit (2009 - 2016)
ANESTHESIA BILLING SPECIALISTS OF FLORIDA INC. - Inactive
Domestic Profit (2009 - 2016)

HOLLAND JULIE H

ANESTHESIA BILLING SPECIALISTS OF FLORIDA INC. - Inactive
Domestic Profit (2009 - 2016)
ANESTHESIA BILLING SPECIALISTS OF FLORIDA INC. - Inactive
Domestic Profit (2009 - 2016)
ANESTHESIA BILLING SPECIALISTS OF FLORIDA INC. - Inactive
Domestic Profit (2009 - 2016)

Companies related by address

No other companies in our directory share the same address as SOUTH LAKE ANESTHESIA SERVICES, P.A.

Date of last update: 03 Apr 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated