| Entity Name: | CENTER FOR VEIN AND VASCULAR DISEASE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 03 Aug 2011 (13 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L11000089071 |
| FEI/EIN Number | 452893829 |
| Address: | 2170 W STATE ROAD 434,, SUITE 190, LONGWOOD, FL, 32779, US |
| Mail Address: | 3275 Tala Loop, Longwood, FL, 32779, US |
| ZIP code: | 32779 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316385404 | 2013-06-11 | 2013-06-11 | 450 W CENTRAL PKWY, SUITE 2000, ALTAMONTE SPRINGS, FL, 327142436, US | 450 W CENTRAL PKWY, SUITE 2000, ALTAMONTE SPRINGS, FL, 327142436, US | |||||||||||||||||||||||||||||||
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| Phone | +1 407-865-7091 |
| Fax | 4078657090 |
Authorized person
| Name | MRS. CHRISTI A HUDIBURG |
| Role | PRACTICE ADMINISTRATOR |
| Phone | 4077678554 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| License Number | MD95035 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1235150103 |
| Issuer | NPI |
| Number | 1407877384 |
| Issuer | NPI |
| Number | 1437122660 |
| Name | Role | Address |
|---|---|---|
| VAKILI BABAK | Agent | 3275 Tala Loop, Longwood, FL, 32779 |
| Name | Role | Address |
|---|---|---|
| VAKILI BABAK | Manager | 3275 TALA LOOP, LONGWOOD, FL, 32779 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-08-13 | 2170 W STATE ROAD 434,, SUITE 190, LONGWOOD, FL 32779 | No data |
| CHANGE OF MAILING ADDRESS | 2015-01-08 | 2170 W STATE ROAD 434,, SUITE 190, LONGWOOD, FL 32779 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-01-08 | 3275 Tala Loop, Longwood, FL 32779 | No data |
| LC NAME CHANGE | 2014-11-14 | CENTER FOR VEIN AND VASCULAR DISEASE LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-01-19 |
| ANNUAL REPORT | 2016-02-12 |
| ANNUAL REPORT | 2015-01-08 |
| LC Name Change | 2014-11-14 |
| ANNUAL REPORT | 2014-04-22 |
| ANNUAL REPORT | 2013-02-17 |
| ANNUAL REPORT | 2012-09-17 |
| Florida Limited Liability | 2011-08-03 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
