| Entity Name: | FLORIDA CANCER PHYSICIANS NETWORK, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
FLORIDA CANCER PHYSICIANS NETWORK, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 24 May 2010 (15 years ago) |
| Date of dissolution: | 27 Sep 2013 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (12 years ago) |
| Document Number: | L10000055664 |
| FEI/EIN Number |
800619649
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 3201 SOUTHWEST 33RD ROAD, OCALA, FL, 34474 |
| Mail Address: | 3201 SOUTHWEST 33RD ROAD, OCALA, FL, 34474 |
| ZIP code: | 34474 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649583170 | 2010-07-26 | 2012-09-24 | 2715 W VIRGINIA AVE, TAMPA, FL, 336076327, US | 7315 GREEN SLOPE DR, ZEPHYRHILLS, FL, 335411314, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-662-6024 |
| Fax | 8135141257 |
| Phone | +1 813-783-8614 |
| Fax | 8137838538 |
Authorized person
| Name | NICK HERNANDEZ |
| Role | VP INDIANA & S FLORIDA OPERATIONS |
| Phone | 8136626024 |
Taxonomy
| Taxonomy Code | 2085R0001X - Radiation Oncology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002715008 |
| State | FL |
| Issuer | RR MEDICARE |
| Number | DR0495 |
| State | FL |
| Issuer | BCBS |
| Number | 0014A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BLALOCK WALTERS, P.A. | Agent | - |
| RAO JAYANTH M | Manager | 3201 SOUTHWEST 33RD ROAD, OCALA, FL, 34474 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000039925 | FLORIDA REGIONAL CANCER CENTER | EXPIRED | 2011-04-26 | 2016-12-31 | - | 3406 N LECANTO HWY, STE A, BEVERLY HILLS, FL, 34465 |
| G11000039926 | MANATEE CANCER CENTER | EXPIRED | 2011-04-26 | 2016-12-31 | - | 6215 21ST AVENUE WEST, SUITE B, BRADENTON, FL, 34209 |
| G11000004271 | SEBRING CANCER CENTER | EXPIRED | 2011-01-07 | 2016-12-31 | - | 3599 UNIVERSITY BLVD SOUTH SUITE 1000, JACKSONVILLE, FL, 32216 |
| G11000004268 | TAMPA BAY CANCER CENTER | EXPIRED | 2011-01-07 | 2016-12-31 | - | 3599 UNIVERSITY BLVD SOUTH SUITE 1000, JACKSONVILLE, FL, 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | - | - |
| LC AMENDMENT | 2012-11-26 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2012-11-26 | 3201 SOUTHWEST 33RD ROAD, OCALA, FL 34474 | - |
| CHANGE OF MAILING ADDRESS | 2012-11-26 | 3201 SOUTHWEST 33RD ROAD, OCALA, FL 34474 | - |
| REGISTERED AGENT NAME CHANGED | 2012-11-26 | BLALOCK WALTERS, P.A. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2012-11-26 | 802 11TH STREET WEST, BRADENTON, FL 34205 | - |
| Name | Date |
|---|---|
| Reg. Agent Resignation | 2015-11-16 |
| LC Amendment | 2012-11-26 |
| ANNUAL REPORT | 2012-03-28 |
| ANNUAL REPORT | 2011-03-10 |
| Florida Limited Liability | 2010-05-24 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
