| Entity Name: | CARDIOLOGY CONSULTANTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 13 Jul 1981 (44 years ago) |
| Date of dissolution: | 20 Jun 1996 (29 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 20 Jun 1996 (29 years ago) |
| Document Number: | 694274 |
| FEI/EIN Number | 59-2106052 |
| Address: | 4800 N.W. 19TH PLACE, GAINESVILLE, FL 32605 |
| Mail Address: | 4800 N.W. 19TH PLACE, GAINESVILLE, FL 32605 |
| ZIP code: | 32605 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548479579 | 2007-05-22 | 2009-11-17 | 2320 N ORANGE AVE, ORLANDO, FL, 328045506, US | 2320 N ORANGE AVE, ORLANDO, FL, 328045506, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-896-0054 |
| Fax | 4078984463 |
Authorized person
| Name | DR. JAMES L BOLEN |
| Role | CEO |
| Phone | 4078960054 |
Taxonomy
| Taxonomy Code | 2471R0002X - Radiation Therapy Radiologic Technologist |
| License Number | 3516-3 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 061472600 |
| State | FL |
| Issuer | MEDICAID |
| Number | 035671900 |
| State | FL |
| Issuer | BLUE CROSS GROUP |
| Number | 99507 |
| State | FL |
| Issuer | MEDICAID |
| Number | 039549800 |
| State | FL |
| Issuer | MEDICAID |
| Number | 048179300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PEPINE,CARL J. | Agent | 4800 NW 19TH PLACE, GAINESVILLE, FL 32605 |
| Name | Role | Address |
|---|---|---|
| PEPINE, M LYNN | Director | 4800 NW 19TH PL, GAINESVILLE, FL 00000 |
| PEPINE, CARL J | Director | 4800 NW 19TH PL, GAINESVILLE, FL 00000 |
| Name | Role | Address |
|---|---|---|
| PEPINE, M LYNN | Secretary | 4800 NW 19TH PL, GAINESVILLE, FL 00000 |
| Name | Role | Address |
|---|---|---|
| PEPINE, M LYNN | Treasurer | 4800 NW 19TH PL, GAINESVILLE, FL 00000 |
| Name | Role | Address |
|---|---|---|
| PEPINE, CARL J | President | 4800 NW 19TH PL, GAINESVILLE, FL 00000 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 1996-06-20 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 1990-03-14 | PEPINE,CARL J. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1990-03-14 | 4800 NW 19TH PLACE, GAINESVILLE, FL 32605 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 1988-03-17 | 4800 N.W. 19TH PLACE, GAINESVILLE, FL 32605 | No data |
| CHANGE OF MAILING ADDRESS | 1988-03-17 | 4800 N.W. 19TH PLACE, GAINESVILLE, FL 32605 | No data |
| NAME CHANGE AMENDMENT | 1986-04-03 | CARDIOLOGY CONSULTANTS, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 1996-02-13 |
| ANNUAL REPORT | 1995-04-03 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
