| Entity Name: | ADVANCED VASCULAR CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 30 Sep 2015 (9 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P15000082353 |
| FEI/EIN Number | 47-5276394 |
| Address: | 4516 HIGHWAY 20 EAST, SUITE 226, NICEVILLE, FL 32578 |
| Mail Address: | 4516 HIGHWAY 20 EAST, SUITE 226, NICEVILLE, FL 32578 |
| ZIP code: | 32578 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518338565 | 2015-10-16 | 2016-01-15 | 4516 E HIGHWAY 20, SUITE 226, NICEVILLE, FL, 325789755, US | 2010 LEWIS TURNER BLVD, FORT WALTON BEACH, FL, 325471352, US | |||||||||||||||||||||||||||||
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| Phone | +1 305-662-5200 |
| Fax | 3052847913 |
Authorized person
| Name | DEBBIE JEAN ANDERSON |
| Role | MEDICAL CLAIM SPECIALIST |
| Phone | 8505438960 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1063852192 |
| Issuer | BC |
| Number | 14V4Q |
| Issuer | MEDICAID |
| Number | 011996100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Calabrese, Emilio | Agent | 4516 HIGHWAY 20 EAST, SUITE 226, NICEVILLE, FL 32578 |
| Name | Role | Address |
|---|---|---|
| CALABRESE, EMILIO C | Director | 4516 HIGHWAY 20 EAST, SUITE 226, NICEVILLE, FL 32578 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REINSTATEMENT | 2018-07-06 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-07-06 | Calabrese, Emilio | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-07-06 | 4516 HIGHWAY 20 EAST, SUITE 226, NICEVILLE, FL 32578 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-06-09 |
| ANNUAL REPORT | 2019-06-14 |
| REINSTATEMENT | 2018-07-06 |
| Domestic Profit | 2015-09-30 |
Date of last update: 19 Feb 2025
Sources: Florida Department of State
