| Entity Name: | FLORIDA ENDOVASCULAR SPECIALISTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 22 Feb 2010 (15 years ago) |
| Date of dissolution: | 06 Mar 2015 (10 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 06 Mar 2015 (10 years ago) |
| Document Number: | L10000019786 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 1673 MASON AVE, STE 305, DAYTONA BEACH, FL, 32117 |
| Mail Address: | P O BOX 48, DAYTONA BEACH, FL, 32115 |
| ZIP code: | 32117 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255644969 | 2010-07-22 | 2010-07-22 | 1673 MASON AVE, SUITE 305, DAYTONA BEACH, FL, 321175515, US | 1890 LPGA BLVD, SUITE 140, DAYTONA BEACH, FL, 321177130, US | |||||||||||||||||||||||||
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| Phone | +1 386-274-7118 |
| Fax | 3862746173 |
| Phone | +1 386-274-7250 |
| Fax | 3862747259 |
Authorized person
| Name | MR. AL FALCO |
| Role | CEO |
| Phone | 3862747118 |
Taxonomy
| Taxonomy Code | 2085R0204X - Vascular & Interventional Radiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD OF FLORIDA |
| Number | 000NN |
| State | FL |
| Name | Role |
|---|---|
| R&A AGENTS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| STONE MELVIN | Manager | P.O. BOX 48, DAYTONA BEACH, FL, 32115 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-03-06 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2015-03-06 |
| ANNUAL REPORT | 2014-01-22 |
| ANNUAL REPORT | 2013-04-12 |
| ANNUAL REPORT | 2012-04-23 |
| ANNUAL REPORT | 2011-04-13 |
| Florida Limited Liability | 2010-02-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
