| Entity Name: | INSTITUTE OF CARDIOVASCULAR EXCELLENCE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 08 Jan 2009 (16 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | L09000002557 |
| FEI/EIN Number | 263999808 |
| Address: | 4730 SW 49TH ROAD, OCALA, FL, 34474, US |
| Mail Address: | 4730 SW 49TH ROAD, OCALA, FL, 34474, US |
| ZIP code: | 34474 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295975803 | 2009-02-23 | 2015-02-04 | 4730 SW 49TH RD, OCALA, FL, 344746262, US | 4730 SW 49TH RD, OCALA, FL, 344746262, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 352-854-0681 |
| Fax | 3528548031 |
Authorized person
| Name | DR. ASAD U QAMAR |
| Role | PRESIDENT |
| Phone | 3528540681 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RI0011X - Interventional Cardiology Physician |
| License Number | ME99096 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001305600 |
| State | FL |
| Issuer | BCBS OF FLORIDA |
| Number | 000CE |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| INSTITUTE OF CARDIOVASCULAR EXCELLENCE, PLLC RETIREMENT PLAN | 2013 | 263999808 | 2014-07-30 | INSTITUTE OF CARDIOVASCULAR EXCELLENCE, PLLC | 100 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 263999808 |
| Plan administrator’s name | INSTITUTE OF CARDIOVASCULAR EXCELLENCE, PLLC |
| Plan administrator’s address | 4730 SW 49TH ROAD, OCALA, FL, 34474 |
| Administrator’s telephone number | 3548540681 |
Signature of
| Role | Plan administrator |
| Date | 2014-07-30 |
| Name of individual signing | ASAD QAMAR |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2011-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3528540681 |
| Plan sponsor’s address | 4730 SW 49TH ROAD, OCALA, FL, 34474 |
Plan administrator’s name and address
| Administrator’s EIN | 263999808 |
| Plan administrator’s name | INSTITUTE OF CARDIOVASCULAR EXCELLENCE, PLLC |
| Plan administrator’s address | 4730 SW 49TH ROAD, OCALA, FL, 34474 |
| Administrator’s telephone number | 3548540681 |
Signature of
| Role | Plan administrator |
| Date | 2013-06-19 |
| Name of individual signing | ASAD QAMAR |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2011-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3528540681 |
| Plan sponsor’s address | 4730 SW 49TH ROAD, OCALA, FL, 34474 |
Plan administrator’s name and address
| Administrator’s EIN | 263999808 |
| Plan administrator’s name | INSTITUTE OF CARDIOVASCULAR EXCELLENCE, PLLC |
| Plan administrator’s address | 4730 SW 49TH ROAD, OCALA, FL, 34474 |
| Administrator’s telephone number | 3548540681 |
Signature of
| Role | Plan administrator |
| Date | 2012-10-12 |
| Name of individual signing | ASAD QAMAR |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| CORTES JOSE H | Agent | 4 SOUTHEAST BROADWAY STREET, OCALA, FL, 34471 |
| Name | Role |
|---|---|
| ICE HOLDINGS, PLLC | Managing Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000101895 | IME | EXPIRED | 2011-10-17 | 2016-12-31 | No data | 4600 SW 45 COURT, SUITE 340, OCALA, FL, 34474 |
| G11000101896 | INSTITUTE OF MEDICAL EXCELLENCE | EXPIRED | 2011-10-17 | 2016-12-31 | No data | 4600 SW 45 COURT, SUITE 340, OCALA, FL, 34474 |
| G09000159747 | INSTITUTE OF CARDIOVASCULAR EXCELLENCE | EXPIRED | 2009-09-28 | 2014-12-31 | No data | C/O JOSE H. CORTES, JR., ESQ., P.O. BOX 1869, OCALA, FL, 34478-1869 |
| G09057900046 | I.C.E. | EXPIRED | 2009-02-26 | 2014-12-31 | No data | C/O JOSE H. CORTES, JR., ESQ., PO BOX 1869, OCALA, FL, 34478-1869 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-08-17 | 4730 SW 49TH ROAD, OCALA, FL 34474 | No data |
| CHANGE OF MAILING ADDRESS | 2012-08-17 | 4730 SW 49TH ROAD, OCALA, FL 34474 | No data |
| LC AMENDED AND RESTATED ARTICLES | 2010-11-08 | No data | No data |
| LC AMENDED AND RESTATED ARTICLES | 2009-10-12 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J15000789442 | LAPSED | 2013 CA 3886 | MARION CO | 2015-07-14 | 2020-07-24 | $282,061.19 | AMERICAN INTERNATIONAL BIOTECHNOLOGY, LLC, 601 BIOTECH DRIVE, RICHMOND, VA 23235 |
| J12000729817 | TERMINATED | 1000000286614 | MARION | 2012-10-17 | 2022-10-25 | $ 454.54 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, ALACHUA SERVICE CENTER, 14107 NW US HIGHWAY 441 STE 100, ALACHUA FL326156390 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-01-12 |
| ANNUAL REPORT | 2014-01-08 |
| ANNUAL REPORT | 2013-03-28 |
| ANNUAL REPORT | 2012-01-05 |
| ANNUAL REPORT | 2011-04-28 |
| LC Amended and Restated Art | 2010-11-08 |
| ANNUAL REPORT | 2010-04-30 |
| LC Amended and Restated Art | 2009-10-12 |
| Florida Limited Liability | 2009-01-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
