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  5. HEART AND VASCULAR CLINIC OF CLERMONT, LLC

HEART AND VASCULAR CLINIC OF CLERMONT, LLC

Company Details

Entity Name: HEART AND VASCULAR CLINIC OF CLERMONT, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 31 May 2011 (14 years ago)
Last Event: LC NAME CHANGE
Event Date Filed: 03 Apr 2013 (12 years ago)
Document Number: L11000063536
FEI/EIN Number 452428293
Address: 1125 HARMONY LN, CLERMONT, FL, 34711, US
Mail Address: 1125 HARMONY LN, CLERMONT, FL, 34711, US
ZIP code: 34711
County: Lake
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1235572405 2013-04-08 2013-06-25 821 OAKLEY SEAVER DR, CLERMONT, FL, 347111968, US 821 OAKLEY SEAVER DR, CLERMONT, FL, 347111968, US

Contacts
Phone +1 352-432-7200

Authorized person
Name OSAMA AL SULEIMAN
Role OWNER
Phone 4074671234

Taxonomy
Taxonomy Code 207RC0000X - Cardiovascular Disease Physician
License Number ME86774
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HEART AND VASCULAR CLINIC OF CLERMONT 401K PLAN 2023 452428293 2024-07-17 HEART AND VASCULAR CLINIC OF CLERMONT 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-10-01
Business code 621111
Sponsor’s telephone number 4074671234
Plan sponsor’s address 3101 CITRUS TOWER BLVD, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2024-07-17
Name of individual signing OSAMA AL-SULEIMAN
Valid signature Filed with authorized/valid electronic signature
HEART AND VASCULAR CLINIC OF CLERMONT 401K PLAN 2022 452428293 2023-10-27 HEART AND VASCULAR CLINIC OF CLERMONT 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-10-01
Business code 621111
Sponsor’s telephone number 4074671234
Plan sponsor’s address 3101 CITRUS TOWER BLVD, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2023-10-27
Name of individual signing OSAMA AL-SULEIMAN
Valid signature Filed with authorized/valid electronic signature
HEART AND VASCULAR CLINIC OF CLERMONT 401K PLAN 2021 452428293 2022-05-23 HEART AND VASCULAR CLINIC OF CLERMONT 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-10-01
Business code 621111
Sponsor’s telephone number 4074671234
Plan sponsor’s address 3101 CITRUS TOWER BLVD, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2022-05-23
Name of individual signing OSAMA AL-SULEIMAN
Valid signature Filed with authorized/valid electronic signature
HEART AND VASCULAR CLINIC OF CLERMONT, LLC 401(K) PLAN 2019 452428293 2020-10-16 HEART AND VASCULAR CLINIC OF CLERMONT, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-10-01
Business code 621111
Sponsor’s telephone number 3524327200
Plan sponsor’s address 3101 CITRUS TOWER BLVD, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2020-10-16
Name of individual signing OSAMA AL-SULEIMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-16
Name of individual signing OSAMA AL-SULEIMAN
Valid signature Filed with authorized/valid electronic signature
HEART AND VASCULAR CLINIC OF CLERMONT, LLC 401(K) PLAN 2018 452428293 2019-10-01 HEART AND VASCULAR CLINIC OF CLERMONT, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-10-01
Business code 621111
Sponsor’s telephone number 3524327200
Plan sponsor’s address 3101 CITRUS TOWER BLVD., CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2019-10-01
Name of individual signing OSAMA AL-SULEIMAN
Valid signature Filed with authorized/valid electronic signature
HEART AND VASCULAR CLINIC OF CLERMONT, LLC 401(K) PLAN 2017 452428293 2018-07-11 HEART AND VASCULAR CLINIC OF CLERMONT, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-10-01
Business code 621111
Sponsor’s telephone number 3524327200
Plan sponsor’s address 3101 CITRUS TOWER BLVD., CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2018-07-11
Name of individual signing OSAMA AL SULEIMAN
Valid signature Filed with authorized/valid electronic signature
HEART AND VASCULAR CLINIC PLAN 2015 452428293 2016-06-21 HEART AND VASCULAR CLINIC OF CLERMONT LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-10-01
Business code 621111
Sponsor’s telephone number 3524327200
Plan sponsor’s address 3101 CITRUS TOWER BLVD, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2016-06-21
Name of individual signing OSAMA AL-SULEIMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
AL-SULEIMAN OSAMA Agent 1125 Harmony Lane, CLERMONT, FL, 34711

Managing Member

Name Role Address
AL-SULEIMAN OSAMA Managing Member 1125 HARMONY LN, CLERMONT, FL, 34711

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2016-03-09 1125 Harmony Lane, CLERMONT, FL 34711 No data
CHANGE OF PRINCIPAL ADDRESS 2014-03-10 1125 HARMONY LN, CLERMONT, FL 34711 No data
CHANGE OF MAILING ADDRESS 2014-03-10 1125 HARMONY LN, CLERMONT, FL 34711 No data
LC NAME CHANGE 2013-04-03 HEART AND VASCULAR CLINIC OF CLERMONT, LLC No data
REGISTERED AGENT NAME CHANGED 2012-03-21 AL-SULEIMAN, OSAMA No data

Documents

Name Date
ANNUAL REPORT 2024-04-05
ANNUAL REPORT 2023-04-01
ANNUAL REPORT 2022-03-01
ANNUAL REPORT 2021-04-27
ANNUAL REPORT 2020-01-15
ANNUAL REPORT 2019-05-28
ANNUAL REPORT 2018-04-04
ANNUAL REPORT 2017-03-30
ANNUAL REPORT 2016-03-09
ANNUAL REPORT 2015-02-25

Related by officers

AL-SULEIMAN OSAMA

SOUTH LAKE CARDIOLOGY, LLC ISLAMIC SOCIETY OF CLERMONT, INC.

Related by address

1125 HARMONY LN, CLERMONT, FL, 34711, US

LUJAZAKE INVESTMENT LLC

1125 HARMONY LN, CLERMONT, FL, 34711, US

LUJAZAKE INVESTMENT LLC

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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