| Entity Name: | VOLUSIA OBL BZ, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Active |
| Date Filed: | 25 Jun 2020 (5 years ago) |
| Document Number: | M20000005659 |
| FEI/EIN Number | 85-1575036 |
| Mail Address: | 231 S Bemiston Ave Ste 850, PMB 82567, Saint Louis, MO 63105-1920 |
| Address: | 1615 Dr Martin Luther King JR BLVD, Deltona, FL 32725 |
| ZIP code: | 32725 |
| County: | Volusia |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003572355 | 2021-11-11 | 2023-09-10 | 231 S BEMISTON AVE STE 850, PMB 82567, SAINT LOUIS, MO, 631051920, US | 1601 LPGA BLVD, DAYTONA BEACH, FL, 32117, US | |||||||||||||||||||
|
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| Phone | +1 727-692-8882 |
| Fax | 7274879041 |
| Phone | +1 618-973-8740 |
| Fax | 6182352556 |
Authorized person
| Name | MS. SHEREE LEPPINEN |
| Role | ADMINISTRATOR |
| Phone | 7276928882 |
Taxonomy
| Taxonomy Code | 207RI0011X - Interventional Cardiology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 |
| Name | Role | Address |
|---|---|---|
| Price, Timothy | Manager | 231 S Bemiston Ave Ste 850, PMB 82567 Saint Louis, MO 63105-1920 |
| CCA MANAGEMENT, LLC | Manager | No data |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000012502 | ADVANCED CARDIOVASCULAR INSTITUTE AT DELTONA | ACTIVE | 2022-01-30 | 2027-12-31 | No data | 231 S BEMISTON AVE SUITE 850, PMB 82567, ST LOUIS, MO, 63105 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-06-13 | 1615 Dr Martin Luther King JR BLVD, Deltona, FL 32725 | No data |
| CHANGE OF MAILING ADDRESS | 2021-05-17 | 1615 Dr Martin Luther King JR BLVD, Deltona, FL 32725 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-22 |
| ANNUAL REPORT | 2023-04-27 |
| AMENDED ANNUAL REPORT | 2022-06-13 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-05-17 |
| Foreign Limited | 2020-06-25 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
