| Entity Name: | HEART RHYTHM SPECIALISTS AT DAYTONA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Jul 2017 (8 years ago) |
| Document Number: | L17000149352 |
| FEI/EIN Number | 82-2178130 |
| Address: | 1240 West Granada Blvd, 2nd floor, Ormond Beach, FL, 32174, US |
| Mail Address: | 1240 West Granada Blvd, 2nd floor, Ormond Beach, FL, 32174, US |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164948360 | 2017-08-18 | 2017-08-18 | 305 MEMORIAL MEDICAL PKWY STE 300, DAYTONA BEACH, FL, 321175170, US | 305 MEMORIAL MEDICAL PKWY STE 300, DAYTONA BEACH, FL, 321175170, US | |||||||||||||||||||||||||
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| Phone | +1 386-672-1023 |
| Fax | 3862632996 |
Authorized person
| Name | MS. YVETTE S ANDERSON |
| Role | CONSULTING MANAGER |
| Phone | 3863160955 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | No |
| Taxonomy Code | 207RC0001X - Clinical Cardiac Electrophysiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 00115440 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WANG HUIJIAN | Agent | 1240 West Granada Blvd, Ormond Beach, FL, 32174 |
| Name | Role | Address |
|---|---|---|
| WANG HUIJIAN | Manager | 1240 West Granada Blvd, Ormond Beach, FL, 32174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-09 | 1240 West Granada Blvd, 2nd floor, Ormond Beach, FL 32174 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-09 | 1240 West Granada Blvd, 2nd floor, Ormond Beach, FL 32174 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-09 | 1240 West Granada Blvd, 2nd floor, Ormond Beach, FL 32174 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-14 |
| ANNUAL REPORT | 2024-01-13 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-01-09 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-01-12 |
| ANNUAL REPORT | 2019-01-12 |
| ANNUAL REPORT | 2018-01-14 |
| Florida Limited Liability | 2017-07-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
