| Entity Name: | PINELLAS VASCULAR, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Mar 2019 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 13 Jun 2023 (2 years ago) |
| Document Number: | L19000083908 |
| FEI/EIN Number | 834262805 |
| Address: | 35 Sandpiper Rd., Tampa, FL, 33609, US |
| Mail Address: | 35 Sandpiper Rd., Tampa, FL, 33609, US |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174173421 | 2019-09-18 | 2024-09-24 | 5260 78TH AVE N # 2776, PINELLAS PARK, FL, 337812347, US | 5880 49TH ST N STE 206, ST PETERSBURG, FL, 337092147, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 727-999-8346 |
| Fax | 8777434465 |
| Phone | +1 813-997-2099 |
Authorized person
| Name | AVIANNE BUNNELL |
| Role | OWNER/ PHYSICIAN |
| Phone | 7279998346 |
Taxonomy
| Taxonomy Code | 2086S0129X - Vascular Surgery Physician |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PINELLAS VASCULAR 401(K) PLAN | 2023 | 834262805 | 2024-07-08 | PINELLAS VASCULAR | 5 | |||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-07-08 |
| Name of individual signing | QIAN LIU |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Roush Alfred S | Agent | 35 Sandpiper Rd., Tampa, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| BUNNELL AVIANNE | Manager | 5880 49TH STREET NORTH, SUITE 206, SAINT PETERSBURG, FL, 33709 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-05-09 | 35 Sandpiper Rd., Tampa, FL 33609 | No data |
| CHANGE OF MAILING ADDRESS | 2024-05-09 | 35 Sandpiper Rd., Tampa, FL 33609 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-05-09 | Roush, Alfred S | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-05-09 | 35 Sandpiper Rd., Tampa, FL 33609 | No data |
| LC AMENDMENT | 2023-06-13 | No data | No data |
| LC DISSOCIATION MEM | 2019-04-03 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-05-09 |
| ANNUAL REPORT | 2024-02-09 |
| LC Amendment | 2023-06-13 |
| ANNUAL REPORT | 2023-01-11 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-14 |
| CORLCDSMEM | 2019-04-03 |
| Florida Limited Liability | 2019-03-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
