| Entity Name: | STUART CARDIOVASCULAR ASSOCIATES, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 25 May 2005 (20 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | L05000052077 |
| FEI/EIN Number | 202907689 |
| Address: | 700 Doctors Court, Leesburg, FL, 34748, US |
| Mail Address: | 700 Doctors Court, Leesburg, FL, 34748, US |
| ZIP code: | 34748 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003851502 | 2006-06-18 | 2020-06-05 | 700 DOCTORS CT, LEESBURG, FL, 347487314, US | 524 SE OSCEOLA ST, SUITE 100, STUART, FL, 349942322, US | |||||||||||||||||||||||||||||||
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| Phone | +1 352-787-9838 |
| Fax | 3527878705 |
| Phone | +1 772-419-2379 |
| Fax | 7724192377 |
Authorized person
| Name | TREVA D. WIDDIS |
| Role | ADMINISTRATOR |
| Phone | 3527879838 |
Taxonomy
| Taxonomy Code | 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS OF FLORIDA |
| Number | 00721 |
| State | FL |
| Issuer | MEDICAID |
| Number | 275299900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WIDDIS TREVA D | Agent | 700 Doctors Court, Leesburg, FL, 34748 |
| Name | Role | Address |
|---|---|---|
| FLORIDA HEART AND VASCULAR SURGEONS,PA | Manager | 700 Doctors Court, Leesburg, FL, 34748 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| LC STMNT OF RA/RO CHG | 2018-08-13 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-08-13 | WIDDIS, TREVA D | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-08-13 | 700 Doctors Court, Leesburg, FL 34748 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-23 | 700 Doctors Court, Leesburg, FL 34748 | No data |
| CHANGE OF MAILING ADDRESS | 2018-04-23 | 700 Doctors Court, Leesburg, FL 34748 | No data |
| LC AMENDMENT | 2013-10-18 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-17 |
| CORLCRACHG | 2018-08-13 |
| ANNUAL REPORT | 2018-04-23 |
| ANNUAL REPORT | 2017-02-20 |
| ANNUAL REPORT | 2016-02-22 |
| ANNUAL REPORT | 2015-03-10 |
| ANNUAL REPORT | 2014-03-04 |
| LC Amendment | 2013-10-18 |
| ANNUAL REPORT | 2013-03-11 |
| ANNUAL REPORT | 2012-04-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
