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LEWIS & KLANCKE CARDIOLOGY, P.A. - Florida Company Profile

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Company Details

Entity Name: LEWIS & KLANCKE CARDIOLOGY, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

LEWIS & KLANCKE CARDIOLOGY, 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: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 01 Mar 1984 (41 years ago)
Last Event: AMENDED AND RESTATED ARTICLES
Event Date Filed: 18 Dec 2014 (11 years ago)
Document Number: G88342
FEI/EIN Number 592385440

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 695 NORTH CLYDE MORRIS BLVD, DAYTONA BEACH, FL, 32114
Mail Address: 695 NORTH CLYDE MORRIS BLVD, DAYTONA BEACH, FL, 32114
ZIP code: 32114
County: Volusia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
WILSON VANCE E Director 695 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL
WEST OSCAR Dr. Director 695 N. CLYDE MORRIS BLVD, DAYTONA BEACH, FL, 32114
BROOME-WEBSTER CHAD LDr. Director 695 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL, 32114
SEIDE HANSCY Dr. Director 695 NORTH CLYDE MORRIS BLVD, DAYTONA BEACH, FL, 32114
Bartholomew Beth HDr. Director 695 NORTH CLYDE MORRIS BLVD, DAYTONA BEACH, FL, 32114
Rayos Glenn HMD Agent 695 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL, 32114
RAYOS GLENN HDr. Director 695 NORTH CLYDE MORRIS BLVD, DAYTONA BEACH, FL, 32114

National Provider Identifier

NPI Number:
1376264788
Certification Date:
2023-10-03

Authorized Person:

Name:
KATHLEEN T PHILLIPS
Role:
CREDENTIALING COORDINATOR
Phone:

Taxonomy:

Selected Taxonomy:
207RI0011X - Interventional Cardiology Physician
Is Primary:
No
Selected Taxonomy:
207UN0901X - Nuclear Cardiology Physician
Is Primary:
No
Selected Taxonomy:
207RC0000X - Cardiovascular Disease Physician
Is Primary:
Yes

Contacts:

Fax:
3862589443
Fax:
3867750761

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000086621 DAYTONA HEART GROUP ACTIVE 2024-07-19 2029-12-31 - 695 N. CLYDE MORRIS BLVD., DAYTONA BEACH, FL, 32114
G08168900375 DAYTONA HEART GROUP EXPIRED 2008-06-16 2013-12-31 - 695 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL, 32114

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2017-01-13 Rayos, Glenn H, MD -
AMENDED AND RESTATEDARTICLES 2014-12-18 - -
REGISTERED AGENT ADDRESS CHANGED 2000-04-21 695 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114 -
NAME CHANGE AMENDMENT 1992-04-27 LEWIS & KLANCKE CARDIOLOGY, P.A. -
CHANGE OF PRINCIPAL ADDRESS 1990-06-15 695 NORTH CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114 -
CHANGE OF MAILING ADDRESS 1990-06-15 695 NORTH CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114 -

Documents

Name Date
ANNUAL REPORT 2024-01-31
ANNUAL REPORT 2023-01-19
ANNUAL REPORT 2022-02-01
ANNUAL REPORT 2021-01-25
ANNUAL REPORT 2020-01-27
ANNUAL REPORT 2019-01-15
ANNUAL REPORT 2018-01-11
ANNUAL REPORT 2017-01-13
ANNUAL REPORT 2016-01-25
ANNUAL REPORT 2015-02-23

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Date of last update: 01 Jun 2025

Sources: Florida Department of State