| Entity Name: | VISTA CARDIOVASCULAR INNOVATIONS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 08 Nov 2022 (2 years ago) |
| Document Number: | L22000479085 |
| FEI/EIN Number | 88-4298212 |
| Address: | 3904 CORTEZ RD WEST, STE 300, BRADENTON, FL 34210 |
| Mail Address: | 3904 CORTEZ RD WEST, STE 300, BRADENTON, FL 34210 |
| ZIP code: | 34210 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629788153 | 2022-11-23 | 2022-11-23 | 3904 CORTEZ RD W STE 300, BRADENTON, FL, 342103204, US | 3904 CORTEZ RD W STE 300, BRADENTON, FL, 342103204, US | |||||||||||||||||||||
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| Phone | +1 941-545-8954 |
Authorized person
| Name | ENRIQUE RIVERA |
| Role | OWNER |
| Phone | 9415458954 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | No |
| Taxonomy Code | 2085R0204X - Vascular & Interventional Radiology Physician |
| Is Primary | No |
| Taxonomy Code | 2086S0129X - Vascular Surgery Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RIVERA, ENRIQUE | Agent | 3904 CORTEZ RD WEST, STE 300, BRADENTON, FL 34210 |
| Name | Role | Address |
|---|---|---|
| Caitlin, DeSousa | Authorized Member | 3904 CORTEZ RD WEST, STE 300 BRADENTON, FL 34210 |
| Name | Role | Address |
|---|---|---|
| Caitlin, DeSousa | Chief Operating Officer | 3904 CORTEZ RD WEST, STE 300 BRADENTON, FL 34210 |
| Name | Role | Address |
|---|---|---|
| Caitlin, DeSousa | Director | 3904 CORTEZ RD WEST, STE 300 BRADENTON, FL 34210 |
| Name | Role | Address |
|---|---|---|
| Caitlin, DeSousa | Manager | 3904 CORTEZ RD WEST, STE 300 BRADENTON, FL 34210 |
| Name | Role | Address |
|---|---|---|
| Caitlin, DeSousa | Authorized Representative | 3904 CORTEZ RD WEST, STE 300 BRADENTON, FL 34210 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-15 |
| ANNUAL REPORT | 2023-04-25 |
| Florida Limited Liability | 2022-11-08 |
Date of last update: 11 Jan 2025
Sources: Florida Department of State
