| Entity Name: | VENICE CARDIOVASCULAR ANESTHESIA ASSOCIATES, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Aug 2002 (22 years ago) |
| Document Number: | L02000020013 |
| FEI/EIN Number | 061643841 |
| Address: | 150 SE 17th St., #503, OCALA, FL, 34471, US |
| Mail Address: | 150 SE 17th St., #503, OCALA, FL, 34471, US |
| ZIP code: | 34471 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043253826 | 2006-06-13 | 2020-08-25 | 150 SE 17TH ST STE 503, OCALA, FL, 344715176, US | 540 THE RIALTO, VENICE, FL, 342852900, US | |||||||||||||||||||||||||||
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| Phone | +1 352-433-2825 |
| Fax | 3524332893 |
Authorized person
| Name | VINCENT C. PALMIRE |
| Role | PARTNER |
| Phone | 3524332825 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 268014900 |
| State | FL |
| Issuer | BCBS OF FLORIDA |
| Number | 34679 |
| State | FL |
| Name | Role |
|---|---|
| CHESTNUT BUSINESS SERVICES, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| PALMIRE VINCENT C | Manager | 150 SE 17th St., OCALA, FL, 34471 |
| DEPUTAT MAKHAIL M | Manager | 150 SE 17th St., OCALA, FL, 34471 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
