| Entity Name: | MANATEE CARDIOLOGY ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 May 2012 (13 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 21 Oct 2019 (5 years ago) |
| Document Number: | M12000002967 |
| FEI/EIN Number | 45-5367757 |
| Address: | 316 MANATEE AVE WEST, BRADENTON, FL, 34205, US |
| Mail Address: | 316 MANATEE AVE WEST, BRADENTON, FL, 34205, US |
| ZIP code: | 34205 |
| County: | Manatee |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720341068 | 2012-06-21 | 2022-01-20 | 367 S GULPH RD, KING OF PRUSSIA, PA, 194063121, US | 316 MANATEE AVE W, BRADENTON, FL, 342058805, US | |||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 941-748-2277 |
Authorized person
| Name | MR. TODD EVANS |
| Role | VP |
| Phone | 6107683300 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RC0001X - Clinical Cardiac Electrophysiology Physician |
| Is Primary | No |
| Taxonomy Code | 207RI0011X - Interventional Cardiology Physician |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 006518100 |
| State | FL |
| Issuer | RR MEDICARE |
| Number | DT1951 |
| State | FL |
| Issuer | BCBS |
| Number | 003RJ |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role |
|---|---|
| INDEPENDENCE MANATEE, LLC | Managing Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000046135 | BRADENTON CARDIOLOGY CENTER | ACTIVE | 2020-04-27 | 2025-12-31 | No data | 316 MANATEE AVE. W, BRADENTON, FL, 34205 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2019-10-21 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-10-21 | CORPORATION SERVICE COMPANY | No data |
| REVOKED FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| LC STMNT OF RA/RO CHG | 2017-01-30 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-01-30 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-07 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-04-16 |
| ANNUAL REPORT | 2020-04-03 |
| REINSTATEMENT | 2019-10-21 |
| ANNUAL REPORT | 2018-04-03 |
| ANNUAL REPORT | 2017-04-06 |
| CORLCRACHG | 2017-01-30 |
| ANNUAL REPORT | 2016-03-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
