| Entity Name: | BREVARD VASCULAR ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 04 Oct 2007 (17 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | CORPORATE MERGER |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | L07000101269 |
| FEI/EIN Number | 260866501 |
| Address: | 1116 GEIGER STREET, ROCKLEDGE, FL, 32955 |
| Mail Address: | 1116 GEIGER STREET, ROCKLEDGE, FL, 32955 |
| ZIP code: | 32955 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184806630 | 2007-11-27 | 2010-08-04 | 150 N SYKES CREEK PKWY, SUITE 300, MERRITT ISLAND, FL, 329533488, US | 1004 BEVERLY DR, SUITE D, ROCKLEDGE, FL, 329552851, US | |||||||||||||||||||||||
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| Phone | +1 321-449-4168 |
| Fax | 3214494164 |
| Phone | +1 321-637-4710 |
| Fax | 3216374715 |
Authorized person
| Name | SANDI LAROCHE |
| Role | MSO CREDENTIALING COORDINATOR |
| Phone | 3214494168 |
Taxonomy
| Taxonomy Code | 2086S0129X - Vascular Surgery Physician |
| License Number | ME91509 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SCHF FAMILY PHYSICIANS | Agent | 1116 GEIGER STREET, ROCKLEDGE, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| SCHF FAMILY PHYSICIANS, INC. | Managing Member | 1116 GEIGER STREET, ROCKLEDGE, FL, 32955 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| MERGER | 2012-09-28 | No data | CORPORATION WAS PART OF A MERGER. QUALIFIED CORPORATION WAS N96000005184. MERGER NUMBER 300000125813 |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-09 | 1116 GEIGER STREET, ROCKLEDGE, FL 32955 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-09 | 1116 GEIGER STREET, ROCKLEDGE, FL 32955 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-04-09 | SCHF FAMILY PHYSICIANS | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-09 | 1116 GEIGER STREET, ROCKLEDGE, FL 32955 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-03-21 |
| ANNUAL REPORT | 2011-04-09 |
| ANNUAL REPORT | 2010-04-22 |
| ANNUAL REPORT | 2009-04-23 |
| ANNUAL REPORT | 2008-09-03 |
| Florida Limited Liability | 2007-10-04 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
