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  5. ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC

ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC

Company Details

Entity Name: ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 23 Oct 2013 (11 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 29 Jul 2022 (3 years ago)
Document Number: L13000149393
FEI/EIN Number 46-3992644
Address: 1240 WEST GRANADA BOULEVARD, ORMOND BEACH, FL 32174
Mail Address: 1240 WEST GRANADA BOULEVARD, ORMOND BEACH, FL 32174
ZIP code: 32174
County: Volusia
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1962831883 2013-11-01 2016-01-08 588 STERTHAUS DR, ORMOND BEACH, FL, 321745128, US 588 STERTHAUS DR, ORMOND BEACH, FL, 321745128, US

Contacts
Phone +1 386-672-9503
Fax 3866720386

Authorized person
Name WILLIAM HAMPTON JOHNSON III
Role OPERATING MANAGER
Phone 3866729503

Taxonomy
Taxonomy Code 2086S0129X - Vascular Surgery Physician
License Number ME36700
State FL
Is Primary No
Taxonomy Code 2086S0129X - Vascular Surgery Physician
License Number ME58979
State FL
Is Primary No
Taxonomy Code 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number ME36700
State FL
Is Primary Yes
Taxonomy Code 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number ME58979
State FL
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 401(K) PROFIT SHARING PLAN 2022 463992644 2023-04-10 ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3866729503
Plan sponsor’s address 150 MASON ROAD, MELROSE, FL, 32666
ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 401(K) PROFIT SHARING PLAN 2021 463992644 2022-07-26 ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3866729503
Plan sponsor’s address 588 STERTHAUS DRIVE, ORMOND BEACH, FL, 32174
ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 401(K) PROFIT SHARING PLAN 2020 463992644 2021-05-03 ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3866729503
Plan sponsor’s address 588 STERTHAUS DRIVE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2021-05-03
Name of individual signing VICKY FULLER
Valid signature Filed with authorized/valid electronic signature
ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 401(K) PROFIT SHARING PLAN 2019 463992644 2020-03-06 ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3866729503
Plan sponsor’s address 588 STERTHAUS DRIVE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2020-03-06
Name of individual signing VICKY FULLER
Valid signature Filed with authorized/valid electronic signature
ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 401(K) PROFIT SHARING PLAN 2018 463992644 2019-04-01 ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3866729503
Plan sponsor’s address 588 STERTHAUS DRIVE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2019-04-01
Name of individual signing VICKY FULLER
Valid signature Filed with authorized/valid electronic signature
ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 401(K) PROFIT SHARING PLAN 2017 463992644 2018-02-19 ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3866729503
Plan sponsor’s address 588 STERTHAUS DRIVE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2018-02-19
Name of individual signing VICKY FULLER
Valid signature Filed with authorized/valid electronic signature
ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 401(K) PROFIT SHARING PLAN 2016 463992644 2017-03-20 ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3866729503
Plan sponsor’s address 588 STERTHAUS DRIVE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2017-03-20
Name of individual signing VICKY FULLER
Valid signature Filed with authorized/valid electronic signature
ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 401(K) PROFIT SHARING PLAN 2015 463992644 2016-06-29 ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3866729503
Plan sponsor’s address 588 STERTHAUS DRIVE, ORMOND BEACH, FL, 32174

Signature of
Role Plan administrator
Date 2016-06-29
Name of individual signing VICKY FULLER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WANG, H. JAMES, M.D. Agent 1240 WEST GRANADA BOULEVARD, ORMOND BEACH, FL 32174

Manager

Name Role Address
WANG, H. JAMES, M.D. Manager 1240 WEST GRANADA BOULEVARD, ORMOND BEACH, FL 32174

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000126449 COASTAL CARDIOVASCULAR & THORACIC ASSOCIATES, PA EXPIRED 2016-11-16 2021-12-31 No data 588 STERTHAUS DR, ORMOND BEACH, FL, 32174-5128
G14000086945 EVOLVES VASCULAR LAB EXPIRED 2014-08-25 2019-12-31 No data 588 STERTHAUS DR, ORMOND BEACH, FL, 32174-5128

Events

Event Type Filed Date Value Description
LC AMENDMENT 2022-07-29 No data No data
CHANGE OF PRINCIPAL ADDRESS 2022-07-29 1240 WEST GRANADA BOULEVARD, ORMOND BEACH, FL 32174 No data
CHANGE OF MAILING ADDRESS 2022-07-29 1240 WEST GRANADA BOULEVARD, ORMOND BEACH, FL 32174 No data
REGISTERED AGENT NAME CHANGED 2022-07-29 WANG, H. JAMES, M.D. No data
REGISTERED AGENT ADDRESS CHANGED 2018-01-17 1240 WEST GRANADA BOULEVARD, ORMOND BEACH, FL 32174 No data

Documents

Name Date
ANNUAL REPORT 2025-01-14
ANNUAL REPORT 2024-01-13
ANNUAL REPORT 2023-01-29
LC Amendment 2022-07-29
ANNUAL REPORT 2022-01-25
ANNUAL REPORT 2021-01-11
ANNUAL REPORT 2020-01-17
ANNUAL REPORT 2019-02-12
ANNUAL REPORT 2018-01-17
ANNUAL REPORT 2017-01-06

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3516437304 2020-04-29 0491 PPP 588 STERTHAUS DR, ORMOND BEACH, FL, 32174
Loan Status Date 2021-06-08
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 80100
Loan Approval Amount (current) 80100
Undisbursed Amount 0
Franchise Name -
Lender Location ID 17616
Servicing Lender Name Seacoast National Bank
Servicing Lender Address 815 Colorado Ave, STUART, FL, 34994-3053
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description New Business or 2 years or less
Project Address ORMOND BEACH, VOLUSIA, FL, 32174-0001
Project Congressional District FL-06
Number of Employees 5
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 17616
Originating Lender Name Seacoast National Bank
Originating Lender Address STUART, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 80901
Forgiveness Paid Date 2021-05-06

Related by officers

WANG, H. JAMES, M.D.

EVOLVES VASCULAR LAB, LLC

Related by address

No related companies by address

Date of last update: 21 Feb 2025

Sources: Florida Department of State

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