Search icon

CONVIVA SPECIALTY, LLC - Florida Company Profile

Company claim

Is this your business?

Get access!

Company Details

Entity Name: CONVIVA SPECIALTY, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 06 Jun 2016 (9 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 03 Aug 2022 (3 years ago)
Document Number: L16000108766
FEI/EIN Number 81-2957926
Address: 500 West Main Street, Louisville, KY, 40202, US
Mail Address: 500 West Main Street, Louisville, KY, 40202, US
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Diamond Susan M Chief Financial Officer 500 West Main Street, Louisville, KY, 40202
Edwards Douglas A Seni 500 West Main Street, Louisville, KY, 40202
Feld Daniel K Asso 500 West Main Street, Louisville, KY, 40202
Marcoux Robert M Vice President 500 West Main Street, Louisville, KY, 40202
Buckingham Renee J President 500 West Main Street, Louisville, KY, 40202
Pabo Erika M Vice President 500 West Main Street, Louisville, KY, 40202
CT CORPORATION SYSTEM Agent 1200 S PINE ISLAND RD, PLANTATION, FL, 33324

National Provider Identifier

NPI Number:
1326498676
Certification Date:
2024-06-21

Authorized Person:

Name:
DR. EVAN JACOBS
Role:
ASSOCIATE VP
Phone:

Taxonomy:

Selected Taxonomy:
207RG0100X - Gastroenterology Physician
Is Primary:
No
Selected Taxonomy:
207T00000X - Neurological Surgery Physician
Is Primary:
No
Selected Taxonomy:
207V00000X - Obstetrics & Gynecology Physician
Is Primary:
No
Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
No
Selected Taxonomy:
207RC0000X - Cardiovascular Disease Physician
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000095846 CONVIVA SENIOR PRIMARY CARE ACTIVE 2024-08-12 2029-12-31 - 500 WEST MAIN STREET, LOUISVILLE, KY, 40202
G24000095847 CONVIVA SENIOR PRIMARY CARE, A CENTERWELL COMPANY ACTIVE 2024-08-12 2029-12-31 - 500 WEST MAIN STREET, LOUISVILLE, KY, 40202
G23000090580 CONVIVA PRIMARY CARE ANYWHERE ACTIVE 2023-08-03 2028-12-31 - 500 WEST MAIN STREET, LOUISEVILLE, KY, 40202, CO
G20000118289 CONVIVA CARE CENTER ACTIVE 2020-09-10 2025-12-31 - 500 WEST MAIN STREET, LOUISVILLE, KY, 40202

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-03-11 500 West Main Street, Louisville, KY 40202 -
CHANGE OF MAILING ADDRESS 2024-03-11 500 West Main Street, Louisville, KY 40202 -
LC STMNT OF RA/RO CHG 2022-08-03 - -
REGISTERED AGENT ADDRESS CHANGED 2022-08-03 1200 S PINE ISLAND RD, PLANTATION, FL 33324 -
REGISTERED AGENT NAME CHANGED 2022-08-03 CT CORPORATION SYSTEM -
MERGER 2020-10-01 - CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 900000206209
LC AMENDMENT AND NAME CHANGE 2020-08-18 CONVIVA SPECIALTY, LLC -

Documents

Name Date
AMENDED ANNUAL REPORT 2024-09-16
ANNUAL REPORT 2024-03-11
ANNUAL REPORT 2023-04-29
CORLCRACHG 2022-08-03
ANNUAL REPORT 2022-04-19
AMENDED ANNUAL REPORT 2021-10-19
ANNUAL REPORT 2021-04-29
Merger 2020-10-01
AMENDED ANNUAL REPORT 2020-08-28
LC Amendment and Name Change 2020-08-18

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 02 Jul 2025

Sources: Florida Department of State