| Entity Name: | DUVAL VASCULAR CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Apr 2015 (10 years ago) |
| Document Number: | L15000070086 |
| FEI/EIN Number | 47-3780610 |
| Mail Address: | 3001 PALM HARBOR BLVD, SUITE A, PALM HARBOR, FL, 34683, US |
| Address: | 915 W. Monroe St., Jacksonville, FL, 32204, US |
| ZIP code: | 32204 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013375195 | 2016-02-04 | 2019-09-24 | 3001 PALM HARBOR BLVD STE A, PALM HARBOR, FL, 346831930, US | 915 W MONROE ST, SUITE 100, JACKSONVILLE, FL, 322041177, US | |||||||||||||||||||||||||||
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| Phone | +1 727-474-0090 |
| Fax | 7274740055 |
| Phone | +1 904-518-1398 |
| Fax | 9045130231 |
Authorized person
| Name | JANET R. DEES |
| Role | MANAGING MEMBER |
| Phone | 7274740090 |
Taxonomy
| Taxonomy Code | 207RI0011X - Interventional Cardiology Physician |
| Is Primary | No |
| Taxonomy Code | 2085R0204X - Vascular & Interventional Radiology Physician |
| Is Primary | No |
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Licata Michael | Agent | 3001 PALM HARBOR BLVD, PALM HARBOR, FL, 34683 |
| Name | Role | Address |
|---|---|---|
| Licata Michael | Chief Executive Officer | 3001 PALM HARBOR BLVD, PALM HARBOR, FL, 34683 |
| Name | Role | Address |
|---|---|---|
| Soskin Audrey | Chief Financial Officer | 3001 PALM HARBOR BLVD, PALM HARBOR, FL, 34683 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-07-23 | Licata, Michael | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-06-14 | 915 W. Monroe St., Suite 100, Jacksonville, FL 32204 | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-30 | 915 W. Monroe St., Suite 100, Jacksonville, FL 32204 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-03-30 | 3001 PALM HARBOR BLVD, SUITE A, PALM HARBOR, FL 34683 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-07-23 |
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-02-22 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-03-24 |
| ANNUAL REPORT | 2020-03-25 |
| ANNUAL REPORT | 2019-03-21 |
| ANNUAL REPORT | 2018-03-16 |
| ANNUAL REPORT | 2017-03-30 |
| ANNUAL REPORT | 2016-03-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
