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CONVIVA SPECIALTY, LLC - Florida Company Profile

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Company Details

Entity Name: CONVIVA SPECIALTY, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

CONVIVA SPECIALTY, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

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

Federal Employer Identification (FEI) Number assigned by the IRS.

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

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Date of last update: 02 Jun 2025

Sources: Florida Department of State