| Entity Name: | THE CARDIOVASCULAR CENTER, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 29 Dec 1967 (57 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 02 Jul 2001 (24 years ago) |
| Document Number: | 600329 |
| FEI/EIN Number | 59-1197654 |
| Address: | 910 WILLISTON PARK PT, SUITE #1000, LAKE MARY, FL 32746-2122 |
| Mail Address: | 910 WILLISTON PARK PT, SUITE #1000, LAKE MARY, FL 32746-2122 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275639478 | 2006-09-15 | 2009-12-07 | 910 WILLISTON PARK PT, STE 1000, LAKE MARY, FL, 327462172, US | 910 WILLISTON PARK PT, STE 1000, LAKE MARY, FL, 327462172, US | |||||||||||||||||||||||||
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| Phone | +1 407-833-8028 |
| Fax | 4078338033 |
Authorized person
| Name | CHRIS BILLETTE |
| Role | PRACTICE ADMINISTRATOR |
| Phone | 4078338028 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | Yes |
| Taxonomy Code | 207UN0901X - Nuclear Cardiology Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS OF FL |
| Number | 54877 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VALLARIO, LAWRENCE E. | Agent | 910 WILLISTON PARK PT, STE 1000, LAKE MARY, FL 32746-2122 |
| Name | Role | Address |
|---|---|---|
| VALLARIO, LAWRENCE | Director | 350 EAGLE CREEK CIR, LAKE MARY, FL 32746 |
| DAVID, WILLIAM J | Director | 303 S. DOVER CT., HEATHROW, FL |
| GRULLON, CARLOS P | Director | 789 HEATHER GLEN CIRLCE, LAKE MARY, FL |
| LOPEZ, WILBERTO | Director | 1656 CHERRY RIDGE DR, HEATHROW, FL 32746 |
| Name | Role | Address |
|---|---|---|
| DAVID, WILLIAM J | Vice President | 303 S. DOVER CT., HEATHROW, FL |
| Name | Role | Address |
|---|---|---|
| VALLARIO, LAWRENCE | President | 350 EAGLE CREEK CIR, LAKE MARY, FL 32746 |
| Name | Role | Address |
|---|---|---|
| GRULLON, CARLOS P | Secretary | 789 HEATHER GLEN CIRLCE, LAKE MARY, FL |
| Name | Role | Address |
|---|---|---|
| LOPEZ, WILBERTO | Treasurer | 1656 CHERRY RIDGE DR, HEATHROW, FL 32746 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2002-03-26 | 910 WILLISTON PARK PT, SUITE #1000, LAKE MARY, FL 32746-2122 | No data |
| CHANGE OF MAILING ADDRESS | 2002-03-26 | 910 WILLISTON PARK PT, SUITE #1000, LAKE MARY, FL 32746-2122 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2002-03-26 | 910 WILLISTON PARK PT, STE 1000, LAKE MARY, FL 32746-2122 | No data |
| NAME CHANGE AMENDMENT | 2001-07-02 | THE CARDIOVASCULAR CENTER, P.A. | No data |
| REGISTERED AGENT NAME CHANGED | 1991-03-06 | VALLARIO, LAWRENCE E. | No data |
| NAME CHANGE AMENDMENT | 1987-10-06 | SANFORD CARDIOLOGY ASSOCIATES, P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-02-28 |
| ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2021-04-21 |
| ANNUAL REPORT | 2020-04-27 |
| ANNUAL REPORT | 2019-02-12 |
| ANNUAL REPORT | 2018-01-26 |
| ANNUAL REPORT | 2017-01-27 |
| ANNUAL REPORT | 2016-04-21 |
| ANNUAL REPORT | 2015-03-06 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1013518310 | 2021-01-16 | 0491 | PPS | 910 Williston Park Pt Ste 1000, Lake Mary, FL, 32746-2163 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1654107200 | 2020-04-15 | 0491 | PPP | 910 WILLISTON PARK PT SUITE #1000, LAKE MARY, FL, 32746-2172 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 06 Feb 2025
Sources: Florida Department of State
