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  5. CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC.

CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC.

Company Details

Entity Name: CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 07 Nov 2003 (21 years ago)
Date of dissolution: 08 Dec 2023 (a year ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 08 Dec 2023 (a year ago)
Document Number: P03000128682
FEI/EIN Number 550852214
Address: 4701 NW 67th Street, P.O. Box 5566, GAINESVILLE, FL, 32627, US
Mail Address: P.O. Box 5566, GAINESVILLE, FL, 32627, US
ZIP code: 32627
County: Alachua
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1124209085 2007-11-20 2007-11-20 1100 NW 8TH AVE, SUITE B, GAINESVILLE, FL, 326012916, US 1100 NW 8TH AVE, SUITE B, GAINESVILLE, FL, 326012916, US

Contacts
Phone +1 352-378-7544
Fax 3523787067

Authorized person
Name DR. ANTHONY V. CAGGIANO SR.
Role PRESIDENT
Phone 3523787544

Taxonomy
Taxonomy Code 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number ME54586
State FL
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS BLUE SHIELD
Number 11884
State FL
Issuer MEDICAID
Number 268510800
State FL
Issuer MEDICARE GROUP #
Number K5308
State FL
Issuer MEDICARE INDIVIDUAL NPI
Number 1790797421
State FL
Issuer AVMED
Number 207843
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
401(K)/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2021 550852214 2022-05-11 CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3522461828
Plan sponsor’s address PO BOX 5566, GAINESVILLE, FL, 32627

Signature of
Role Plan administrator
Date 2022-05-11
Name of individual signing ANTHONY CAGGIANO
Valid signature Filed with authorized/valid electronic signature
401(K)/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2018 550852214 2019-06-01 CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3522461828
Plan sponsor’s address P.O. BOX 5566, GAINESVILLE, FL, 32627

Signature of
Role Plan administrator
Date 2019-06-01
Name of individual signing ANTHONY CAGGIANO
Valid signature Filed with authorized/valid electronic signature
DEFINED BENEFIT PENSION PLAN AND TRUST FOR EMPLOYEES OF CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2017 550852214 2018-05-04 CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3522461828
Plan sponsor’s address PO BOX 5566, GAINESVILLE, FL, 32627

Signature of
Role Plan administrator
Date 2018-05-04
Name of individual signing ANTHONY CAGGIANO
Valid signature Filed with authorized/valid electronic signature
401(K)/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2017 550852214 2018-05-04 CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3522461828
Plan sponsor’s address P.O. BOX 5566, GAINESVILLE, FL, 32627

Signature of
Role Plan administrator
Date 2018-05-04
Name of individual signing ANTHONY CAGGIANO
Valid signature Filed with authorized/valid electronic signature
DEFINED BENEFIT PENSION PLAN AND TRUST FOR EMPLOYEES OF CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2016 550852214 2017-07-07 CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3522461828
Plan sponsor’s address PO BOX 5566, GAINESVILLE, FL, 32627

Signature of
Role Plan administrator
Date 2017-07-07
Name of individual signing ANTHONY CAGGIANO
Valid signature Filed with authorized/valid electronic signature
401(K)/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2016 550852214 2017-06-01 CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3522461828
Plan sponsor’s address P.O. BOX 5566, GAINESVILLE, FL, 32627

Signature of
Role Plan administrator
Date 2017-06-01
Name of individual signing ANTHONY CAGGIANO
Valid signature Filed with authorized/valid electronic signature
401(K)/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2015 550852214 2016-07-26 CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3522461828
Plan sponsor’s address P.O. BOX 5566, GAINESVILLE, FL, 32627

Signature of
Role Plan administrator
Date 2016-07-26
Name of individual signing ANTHONY CAGGIANO
Valid signature Filed with authorized/valid electronic signature
DEFINED BENEFIT PENSION PLAN AND TRUST FOR EMPLOYEES OF CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2015 550852214 2016-07-26 CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3522461828
Plan sponsor’s address PO BOX 5566, GAINESVILLE, FL, 32627

Signature of
Role Plan administrator
Date 2016-07-26
Name of individual signing ANTHONY CAGGIANO
Valid signature Filed with authorized/valid electronic signature
401(K)/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2014 550852214 2015-09-09 CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3523787544
Plan sponsor’s DBA name RY ASSOCIATES, INC.
Plan sponsor’s address 1100 NW 8TH AVENUE SUITE B, GAINESVILLE, FL, 32601

Plan administrator’s name and address
Administrator’s EIN 550852214
Plan administrator’s name CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC.
Plan administrator’s address 1100 NW 8TH AVENUE SUITE B, GAINESVILLE, FL, 32601
Administrator’s telephone number 3523787544

Signature of
Role Plan administrator
Date 2015-09-09
Name of individual signing ANTHONY CAGGIANO
Valid signature Filed with authorized/valid electronic signature
DEFINED BENEFIT PENSION PLAN AND TRUST FOR EMPLOYEES OF CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2014 550852214 2015-08-06 CARDIAC AND VASCULAR SURGERY ASSOCIATES, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3523787544
Plan sponsor’s address PO BOX 5566, GAINESVILLE, FL, 32627

Signature of
Role Plan administrator
Date 2015-08-06
Name of individual signing ANTHONY CAGGIANO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CAGGIANO ANTHONY V Agent 4701 NW 67th Street, GAINESVILLE, FL, 32627

Director

Name Role Address
CAGGIANO ANTHONY V Director P.O. Box 5566, GAINESVILLE, FL, 32627

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2023-12-08 No data No data
CHANGE OF PRINCIPAL ADDRESS 2019-03-01 4701 NW 67th Street, P.O. Box 5566, GAINESVILLE, FL 32627 No data
CHANGE OF MAILING ADDRESS 2016-03-25 4701 NW 67th Street, P.O. Box 5566, GAINESVILLE, FL 32627 No data
REGISTERED AGENT ADDRESS CHANGED 2016-03-25 4701 NW 67th Street, P.O. Box 5566, GAINESVILLE, FL 32627 No data
REGISTERED AGENT NAME CHANGED 2012-03-27 CAGGIANO, ANTHONY VSR No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2023-12-08
ANNUAL REPORT 2023-04-11
ANNUAL REPORT 2022-04-06
ANNUAL REPORT 2021-02-05
ANNUAL REPORT 2020-04-14
ANNUAL REPORT 2019-03-01
ANNUAL REPORT 2018-03-23
ANNUAL REPORT 2017-04-13
ANNUAL REPORT 2016-03-25
ANNUAL REPORT 2015-04-23

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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