| Entity Name: | EUGENIO T. VANO JR., M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 27 Feb 2004 (21 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | P04000038358 |
| FEI/EIN Number | 341983165 |
| Address: | 5672 bear stone run, OVIEDO, FL, 32765, US |
| Mail Address: | 5672 bear stone run, OVIEDO, FL, 32765, US |
| ZIP code: | 32765 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871754838 | 2008-06-23 | 2008-06-23 | 230 BENMORE DR, WINTER PARK, FL, 327924101, US | 230 BENMORE DR, WINTER PARK, FL, 327924101, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 407-628-5828 |
| Fax | 4076288837 |
Authorized person
| Name | EUGENIO T VANO JR. |
| Role | PRESIDENT |
| Phone | 4076285828 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME40246 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 068986600 |
| State | FL |
| Issuer | UPIN |
| Number | D57076 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EUGENIO T. VANO JR., M.D., P.A. PROFIT SHARING PLAN | 2009 | 341983165 | 2010-10-15 | EUGENIO T. VANO JR., M.D., P.A. | 2 | |||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 341983165 |
| Plan administrator’s name | EUGENIO T. VANO JR., M.D., P.A. |
| Plan administrator’s address | 230 BENMORE DR., WINTER PARK, FL, 327924101 |
| Administrator’s telephone number | 4076285828 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-15 |
| Name of individual signing | EUGENIO T VANO JR MD |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-10-15 |
| Name of individual signing | EUGENIO T VANO JR MD |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1984-12-31 |
| Business code | 621111 |
| Sponsor’s telephone number | 4076285828 |
| Plan sponsor’s address | 230 BENMORE DR., WINTER PARK, FL, 327924101 |
Plan administrator’s name and address
| Administrator’s EIN | 341983165 |
| Plan administrator’s name | EUGENIO T. VANO JR., M.D., P.A. |
| Plan administrator’s address | 230 BENMORE DR., WINTER PARK, FL, 327924101 |
| Administrator’s telephone number | 4076285828 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-14 |
| Name of individual signing | EUGENIO T VANO JR |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-10-14 |
| Name of individual signing | EUGENIO T VANO JR |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| SPIEGEL & UTRERA, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| VANO JR., M.D. EUGENIO T | Director | 230 BENMORE DR, WINTER PARK, FL, 32792 |
| Name | Role | Address |
|---|---|---|
| VANO JR., M.D. EUGENIO T | President | 230 BENMORE DR, WINTER PARK, FL, 32792 |
| Name | Role | Address |
|---|---|---|
| VANO CARMEN G | Secretary | 230 BENMORE DR, WINTER PARK, FL, 32792 |
| Name | Role | Address |
|---|---|---|
| VANO CARMEN G | Treasurer | 230 BENMORE DR, WINTER PARK, FL, 32792 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-21 | 5672 bear stone run, OVIEDO, FL 32765 | No data |
| CHANGE OF MAILING ADDRESS | 2018-03-21 | 5672 bear stone run, OVIEDO, FL 32765 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-20 |
| ANNUAL REPORT | 2018-03-21 |
| ANNUAL REPORT | 2017-04-11 |
| ANNUAL REPORT | 2016-01-20 |
| ANNUAL REPORT | 2015-01-12 |
| ANNUAL REPORT | 2014-02-21 |
| ANNUAL REPORT | 2013-01-28 |
| ANNUAL REPORT | 2012-01-13 |
| ANNUAL REPORT | 2011-03-22 |
| ANNUAL REPORT | 2010-01-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
