| Entity Name: | THE CARDIAC AND VASCULAR INSTITUTE AMBULATORY SURGERY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Feb 2020 (5 years ago) |
| Document Number: | L20000049127 |
| FEI/EIN Number | 85-1809741 |
| Address: | 4645 NW 8TH AVE, GAINESVILLE, FL, 32605, US |
| Mail Address: | 4645 NW 8TH AVE, GAINESVILLE, FL, 32605, US |
| ZIP code: | 32605 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427690775 | 2019-10-08 | 2021-02-12 | 4645 NW 8TH AVE, GAINESVILLE, FL, 326054524, US | 4645 NW 8TH AVE STE 10, GAINESVILLE, FL, 326054688, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 352-333-7025 |
| Fax | 3523337026 |
Authorized person
| Name | LYNNE MERCANDANTE |
| Role | DIRECTOR |
| Phone | 3523751212 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | No |
| Taxonomy Code | 207RC0001X - Clinical Cardiac Electrophysiology Physician |
| Is Primary | No |
| Taxonomy Code | 207RI0011X - Interventional Cardiology Physician |
| Is Primary | No |
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 2086S0129X - Vascular Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CAPUTO CHRISTOPHER | Agent | 1151 NW 64TH TERR, GAINESVILLE, FL, 32605 |
| Name | Role | Address |
|---|---|---|
| JANSEN MICHAEL Dr. | Manager | 4645 NW 8TH AVE, GAINESVILLE, FL, 32605 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-04-15 | CAPUTO, CHRISTOPHER | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-15 | 1151 NW 64TH TERR, GAINESVILLE, FL 32605 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-02-12 | 4645 NW 8TH AVE, SUITE 10, GAINESVILLE, FL 32605 | No data |
| CHANGE OF MAILING ADDRESS | 2021-02-12 | 4645 NW 8TH AVE, SUITE 10, GAINESVILLE, FL 32605 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-15 |
| ANNUAL REPORT | 2021-02-12 |
| Florida Limited Liability | 2020-02-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
