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  5. LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C.

LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C. - Florida Company Profile

Company Details

Entity Name: LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C.
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C. is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act
Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 01 Oct 1998 (27 years ago)
Date of dissolution: 27 Sep 2024 (7 months ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2024 (7 months ago)
Document Number: L98000002070
FEI/EIN Number 651080050

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 700 Doctors Court, Leesburg, FL, 34748, US
Mail Address: 700 Doctors Court, Leesburg, FL, 34748, US
ZIP code: 34748
County: Lake
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1952346017 2006-06-20 2020-06-29 700 DOCTORS CT, LEESBURG, FL, 347487314, US 700 DOCTORS CT, LEESBURG, FL, 347487314, US

Contacts
Phone +1 352-787-9838
Fax 3527878705

Authorized person
Name TREVA D WIDDIS
Role ADMINISTRATOR
Phone 3527879838

Taxonomy
Taxonomy Code 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 255785100
State FL
Issuer BCBS OF FLORIDA
Number 21949
State FL

Key Officers & Management

Name Role Address
Cook R. DDr. Agent 700 Doctors Court, Leesburg, FL, 34748
Cook R. DDr. Officer 700 Doctors Court, Leesburg, FL, 34748
Richrdson Robert JDr. Officer 700 Doctors Court, Leesburg, FL, 34748

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000084207 VILLAGES HEART SURGERY EXPIRED 2014-08-15 2019-12-31 - PO BOX 3130, OCALA, FL, 34478-3130

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2024-09-27 - -
REGISTERED AGENT NAME CHANGED 2022-04-08 Cook, R. Duane, Dr. -
LC STMNT OF RA/RO CHG 2018-08-13 - -
REGISTERED AGENT ADDRESS CHANGED 2018-08-13 700 Doctors Court, Leesburg, FL 34748 -
CHANGE OF PRINCIPAL ADDRESS 2018-04-23 700 Doctors Court, Leesburg, FL 34748 -
CHANGE OF MAILING ADDRESS 2018-04-23 700 Doctors Court, Leesburg, FL 34748 -
LC AMENDMENT 2013-10-18 - -

Documents

Name Date
ANNUAL REPORT 2023-04-28
ANNUAL REPORT 2022-04-08
ANNUAL REPORT 2021-04-15
ANNUAL REPORT 2020-03-16
ANNUAL REPORT 2019-04-04
CORLCRACHG 2018-08-13
ANNUAL REPORT 2018-04-23
ANNUAL REPORT 2017-02-20
ANNUAL REPORT 2016-02-17
ANNUAL REPORT 2015-03-10

USAspending Awards. Contracts

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
PO AWARD DJBP0302JB210296 2010-06-04 2010-07-04 2010-07-04
Unique Award Key CONT_AWD_DJBP0302JB210296_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description
Title OUTSIDE MEDICAL CARE
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q201: GENERAL HEALTH CARE SERVICES

Recipient Details
Recipient LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C.
UEI S8K3Q5M8GK57
Legacy DUNS 828743224
Recipient Address 700 DOCTORS CT, LEESBURG, 347487314, UNITED STATES
PO AWARD DJBP0302JB210267 2010-06-02 2010-07-02 2010-07-02
Unique Award Key CONT_AWD_DJBP0302JB210267_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description
Title OUTSIDE MEDICAL CARE
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q201: GENERAL HEALTH CARE SERVICES

Recipient Details
Recipient LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C.
UEI S8K3Q5M8GK57
Legacy DUNS 828743224
Recipient Address 700 DOCTORS CT, LEESBURG, 347487314, UNITED STATES
DO AWARD DJBP0302JB210023 2009-12-01 2010-01-01 2010-01-01
Unique Award Key CONT_AWD_DJBP0302JB210023_1540_DJBCOABPA0027_1540
Awarding Agency Department of Justice
Link View Page

Description
Title MEDICAL CARE FOR INMATE
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes Q201: GENERAL HEALTH CARE SERVICES

Recipient Details
Recipient LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C.
UEI S8K3Q5M8GK57
Legacy DUNS 828743224
Recipient Address 700 DOCTORS CT, LEESBURG, 347487314, UNITED STATES
PO AWARD DJBP0302JB210022 2009-12-01 2010-01-01 2010-01-01
Unique Award Key CONT_AWD_DJBP0302JB210022_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description
Title MEDICAL CARE SERVICES FOR INMATE
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)

Recipient Details
Recipient LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C.
UEI S8K3Q5M8GK57
Legacy DUNS 828743224
Recipient Address 700 DOCTORS CT, LEESBURG, 347487314, UNITED STATES
DO AWARD DJBCOAIB211199 2009-07-17 2009-09-19 2009-09-19
Unique Award Key CONT_AWD_DJBCOAIB211199_1540_DJBCOABPA0027_1540
Awarding Agency Department of Justice
Link View Page

Description
Title MEDICAL CARE FOR INMATES
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes Q201: GENERAL HEALTH CARE SERVICES

Recipient Details
Recipient LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C.
UEI S8K3Q5M8GK57
Legacy DUNS 828743224
Recipient Address 700 DOCTORS CT, LEESBURG, 347487314, UNITED STATES
PO AWARD DJBCOAIB210863 2009-04-21 2009-05-21 2009-05-21
Unique Award Key CONT_AWD_DJBCOAIB210863_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description
Title MEDICAL CARE SERVICES FOR INMATE

Recipient Details
Recipient LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C.
UEI S8K3Q5M8GK57
Legacy DUNS 828743224
Recipient Address 700 DOCTORS CT, LEESBURG, 347487314, UNITED STATES
PO AWARD DJBCOAIB210244 2008-11-26 2008-12-26 2008-12-26
Unique Award Key CONT_AWD_DJBCOAIB210244_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description
Title MEDICAL CARE SERVICES FOR INMATE

Recipient Details
Recipient LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C.
UEI S8K3Q5M8GK57
Legacy DUNS 828743224
Recipient Address 700 DOCTORS CT, LEESBURG, 347487314, UNITED STATES
PO AWARD DJBCOAHB211497 2008-11-07 2008-12-07 2008-12-07
Unique Award Key CONT_AWD_DJBCOAHB211497_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description
Title MEDICAL CARE SERVICES FOR INMATE

Recipient Details
Recipient LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C.
UEI S8K3Q5M8GK57
Legacy DUNS 828743224
Recipient Address 700 DOCTORS CT, LEESBURG, 347487314, UNITED STATES
PO AWARD DJBCOAIB210079 2008-11-07 2008-12-07 2008-12-07
Unique Award Key CONT_AWD_DJBCOAIB210079_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description
Title MEDICAL CARE SERVICES FOR INMATE

Recipient Details
Recipient LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C.
UEI S8K3Q5M8GK57
Legacy DUNS 828743224
Recipient Address 700 DOCTORS CT, LEESBURG, 347487314, UNITED STATES
PO AWARD DJBCOAHB211496 2008-11-07 2008-12-07 2008-12-07
Unique Award Key CONT_AWD_DJBCOAHB211496_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description
Title MEDICAL CARE SERVICES FOR INMATE

Recipient Details
Recipient LEESBURG CARDIOVASCULAR ASSOCIATES, L.L.C.
UEI S8K3Q5M8GK57
Legacy DUNS 828743224
Recipient Address 700 DOCTORS CT, LEESBURG, 347487314, UNITED STATES

Companies related by officers

Cook R. DDr.

FLORIDA HEART AND VASCULAR SURGEONS, P.A. - Inactive
Domestic Profit (1987 - 2024)

Companies related by address

700 Doctors Court, Leesburg, FL, 34748, US

VILLAGES HEART SURGERY, LLC CITRUS CARDIOVASCULAR ASSOCIATES, P.L. OCALA HEART INSTITUTE FOUNDATION, INC. LEESBURG-OCALA HEART INSTITUTE BUILDING, L.L.C. STUART CARDIOVASCULAR ASSOCIATES, PLLC

700 Doctors Court, Leesburg, FL, 34748, US

VILLAGES HEART SURGERY, LLC CITRUS CARDIOVASCULAR ASSOCIATES, P.L. OCALA HEART INSTITUTE FOUNDATION, INC. LEESBURG-OCALA HEART INSTITUTE BUILDING, L.L.C. STUART CARDIOVASCULAR ASSOCIATES, PLLC

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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