| Entity Name: | CARDIOVASCULAR SPECIALISTS OF SOUTH FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 04 Jan 2006 (19 years ago) |
| Date of dissolution: | 26 Sep 2008 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2008 (16 years ago) |
| Document Number: | L06000001010 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 10025 CLEARY BLVD, PLANTATION, FL, 33324 |
| Mail Address: | 10025 CLEARY BLVD, PLANTATION, FL, 33324 |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922012087 | 2006-07-27 | 2011-06-26 | 10650 W STATE ROAD 84, SUITE 104, DAVIE, FL, 333244235, US | 10650 W STATE ROAD 84, SUITE 104, DAVIE, FL, 333244235, US | |||||||||||||||||||||||
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| Phone | +1 954-382-1550 |
| Fax | 9543821250 |
Authorized person
| Name | RANDY BRUCE GOULD |
| Role | PRESIDENT |
| Phone | 9543821550 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 269718100 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARDIOVASCULAR SPECIALISTS OF SOUTH FLORIDA CASH BALANCE PLAN | 2019 | 200337721 | 2020-10-14 | CARDIOVASCULAR SPECIALISTS OF SOUTH FLORIDA | 22 | |||||||||||||
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| CARDIOVASCULAR SPECIALISTS OF SOUTH FLORIDA CASH BALANCE PLAN | 2018 | 200337721 | 2019-10-15 | CARDIOVASCULAR SPECIALISTS OF SOUTH FLORIDA | 18 | |||||||||||||
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| CARDIOVASCULAR SPECIALISTS OF SOUTH FLORIDA CASH BALANCE PLAN | 2017 | 200337721 | 2018-09-26 | CARDIOVASCULAR SPECIALISTS OF SOUTH FLORIDA | 16 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| GOULD RANDY | Agent | 10025 CLEARY BLVD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| GOULD RANDY | Managing Member | 10025 CLEARY BLVD, PLANTATION, FL, 33324 |
| SABBOTA MARK | Managing Member | 10025 CLEARY BLVD, PLANTATION, FL, 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-03-29 | 10025 CLEARY BLVD, PLANTATION, FL 33324 | No data |
| CHANGE OF MAILING ADDRESS | 2007-03-29 | 10025 CLEARY BLVD, PLANTATION, FL 33324 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-03-29 | GOULD, RANDY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-03-29 | 10025 CLEARY BLVD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2007-03-29 |
| Florida Limited Liability | 2006-01-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
