| Entity Name: | CANCER SERVICES OF AVENTURA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Sep 2007 (17 years ago) |
| Document Number: | M07000005382 |
| FEI/EIN Number | 010903337 |
| Address: | ONE PARK PLAZA, NASHVILLE, TN, 37203 |
| Mail Address: | ONE PARK PLAZA, LEGAL DEPT., NASHVILLE, TN, 37203 |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790973063 | 2007-10-11 | 2012-05-02 | 20950 NORTH EAST 27TH COURT, AVENTURA, FL, 33180, US | 20950 NE 27TH CT, AVENTURA, FL, 331801232, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 305-682-2151 |
| Fax | 3057925851 |
Authorized person
| Name | JOAN R GLADNEY |
| Role | REGIONAL DIRECTOR |
| Phone | 3524746190 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RR MEDICARE |
| Number | DN4845 |
| State | FL |
| Issuer | BCBS |
| Number | 00575 |
| State | FL |
| Issuer | MEDICAID |
| Number | 279822100 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| WYATT CHRISTOPHER F | Manager | ONE PARK PLAZA, NASHVILLE, TN, 37203 |
| HAZEN SAMUEL N | Manager | ONE PARK PLAZA, NASHVILLE, TN, 37203 |
| Foster Jon M | Manager | ONE PARK PLAZA, NASHVILLE, TN, 37203 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000166687 | HCA FLORIDA AVENTURA HOSPITAL CANCER CENTER | ACTIVE | 2021-12-16 | 2026-12-31 | No data | ONE PARK PLAZA, LEGAL DEPT., NASHVILLE, TN, 37203 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2012-04-27 | ONE PARK PLAZA, NASHVILLE, TN 37203 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-04-22 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-04-29 |
| ANNUAL REPORT | 2019-04-17 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-04-21 |
| ANNUAL REPORT | 2016-04-22 |
| ANNUAL REPORT | 2015-04-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
