| Entity Name: | PREMIER CARDIOLOGY OF VERO BEACH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 May 2023 (2 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 15 Jun 2023 (2 years ago) |
| Document Number: | L23000256416 |
| FEI/EIN Number | 93-1590162 |
| Address: | 787 37TH ST, E250, VERO BEACH, FL, 32960, US |
| Mail Address: | 787 37th Street Suite 250, Vero Beach, FL, 32960, US |
| ZIP code: | 32960 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114701497 | 2023-08-21 | 2023-10-24 | 787 37TH ST STE 250, VERO BEACH, FL, 329607305, US | 787 37TH ST STE 250, VERO BEACH, FL, 329607305, US | |||||||||||||||||||
|
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| Phone | +1 772-494-0794 |
| Fax | 7724940745 |
Authorized person
| Name | VIKRANTH GONGIDI |
| Role | CEO |
| Phone | 7724940794 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GONGIDI VIKRANTH | Agent | 787 37th Street Suite 250, Vero Beach, FL, 32960 |
| Name | Role | Address |
|---|---|---|
| Gongidi Vikranth | Manager | 787 37th Street Suite 250, Vero Beach, FL, 32960 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-03-13 | 787 37TH ST, E250, VERO BEACH, FL 32960 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-13 | 787 37th Street Suite 250, Vero Beach, FL 32960 | No data |
| LC AMENDMENT | 2023-06-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-13 |
| LC Amendment | 2023-06-15 |
| Florida Limited Liability | 2023-05-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
