| Entity Name: | THE HEART INSTITUTE OF VENICE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Apr 2005 (20 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 24 Oct 2013 (11 years ago) |
| Document Number: | L05000032789 |
| FEI/EIN Number | 202641604 |
| Address: | 1370 E VENICE AVE SUITE 102, VENICE, FL, 34285, US |
| Mail Address: | 1370 East Venice Avenue, THE HEART INSTITUTE OF VENICE, PLLC, Venice, FL, 34285, US |
| ZIP code: | 34285 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437114642 | 2006-04-19 | 2024-10-21 | 1370 EAST VENICE AVE, SUITE 102, VENICE, FL, 342859082, US | 1370 EAST VENICE AVE, SUITE 102, VENICE, FL, 342859082, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 941-412-0026 |
| Fax | 9414120027 |
Authorized person
| Name | ALLISON KHAN |
| Role | CREDENTIALING SPECIALIST |
| Phone | 8508679831 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | No |
| Taxonomy Code | 207RI0011X - Interventional Cardiology Physician |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MCR RR |
| Number | DD8693 |
| State | FL |
| Issuer | BCBS |
| Number | 94996 |
| State | FL |
| Issuer | MEDICAID |
| Number | 274068100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Ali Zaid A. | Agent | 9549 New Waterford Cove, Delray Beach, FL, 33446 |
| Name | Role |
|---|---|
| ADVANCED HEALTH CARDIOLOGY, LLC | Auth |
| Name | Role | Address |
|---|---|---|
| Ali Zaid | Manager | 9549 New Waterford Cove, Delray Beach, FL, 33446 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G05189700018 | HEART INSTITUTE OF VENICE | ACTIVE | 2005-07-08 | 2025-12-31 | No data | 1370 EAST VENICE AVENUE, SUITE 102, VENICE, FL, 34285 |
| G05116900252 | THE HEART INSTITUTE OF VENICE | ACTIVE | 2005-04-26 | 2025-12-31 | No data | 1370 EAST VENICE AVE, SUITE 102, VENICE, FL, 34285 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-05-31 | 9549 New Waterford Cove, Delray Beach, FL 33446 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-05-31 | Ali, Zaid A, . | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-20 | 1370 E VENICE AVE SUITE 102, VENICE, FL 34285 | No data |
| LC AMENDMENT | 2013-10-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-06-22 | 1370 E VENICE AVE SUITE 102, VENICE, FL 34285 | No data |
| AMENDMENT | 2005-06-21 | No data | No data |
| NAME CHANGE AMENDMENT | 2005-04-15 | THE HEART INSTITUTE OF VENICE, PLLC | No data |
| NAME CHANGE AMENDMENT | 2005-04-07 | CARDIOLOGY ASSOCIATES OF VENICE & ENGLEWOOD, PLLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| AMENDED ANNUAL REPORT | 2023-05-31 |
| ANNUAL REPORT | 2023-02-28 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-01-20 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-06-13 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-03-22 |
| ANNUAL REPORT | 2016-03-08 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
