| Entity Name: | CARDIAC SURGICAL ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 21 Jan 1998 (27 years ago) |
| Date of dissolution: | 15 Sep 2006 (18 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 15 Sep 2006 (18 years ago) |
| Document Number: | P98000006407 |
| FEI/EIN Number | 593492238 |
| Address: | 455 PINELLAS STREET, SUITE 320, CLEARWATER, FL, 33756, US |
| Mail Address: | 455 PINELLAS STREET, SUITE 320, CLEARWATER, FL, 33756, US |
| ZIP code: | 33756 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821093220 | 2005-06-14 | 2014-05-09 | 6006 49TH ST N, STE 310, ST PETERSBURG, FL, 337092149, US | 6006 49TH ST N, STE 310, ST PETERSBURG, FL, 337092149, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 727-527-9779 |
| Fax | 7275220415 |
Authorized person
| Name | MONIQUE PATRICK |
| Role | PRACTICE MANAGER |
| Phone | 7275279779 |
Taxonomy
| Taxonomy Code | 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | WELLCARE |
| Number | 133851 |
| State | FL |
| Issuer | CIGNA |
| Number | 1040683001 |
| State | FL |
| Issuer | AETNA |
| Number | 3303663 |
| State | FL |
| Issuer | AMERIGROUP |
| Number | 213046 |
| State | FL |
| Issuer | AVMED |
| Number | 239304 |
| State | FL |
| Issuer | HUMANA |
| Number | 2122308 |
| State | FL |
| Issuer | MEDICAID |
| Number | 254837200 |
| State | FL |
| Issuer | UNITED |
| Number | 18-00123 |
| Name | Role | Address |
|---|---|---|
| MURBACH RICHARD A | Agent | 455 PINELLAS STREET, CLEARWATER, FL, 33756 |
| Name | Role | Address |
|---|---|---|
| DWORKIN GARY H | Director | 455 PINELLAS STREET SUITE 320, CLEARWATER, FL, 33756 |
| BOTERO LUIS | Director | 455 PINELLAS STREET SUITE 320, CLEARWATER, FL, 33756 |
| JACOBS JEFFERY | Director | 455 PINELLAS STREET SUITE 320, CLEARWATER, FL, 33756 |
| FEASTER LYNN B | Director | 455 PINELLAS STREET, SUITE 320, CLEARWATER, FL, 33756 |
| VAN GELDER HUGH M | Director | 603 7TH STREET SOUTH SUITE 450, CLEARWATER, FL, 33756 |
| Name | Role | Address |
|---|---|---|
| MURBACH RICHARD H | President | 455 PINELLAS ST. SUITE 320, CLEARWATER, FL, 33756 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2002-05-02 | MURBACH, RICHARD A | No data |
| CHANGE OF PRINCIPAL ADDRESS | 1999-07-21 | 455 PINELLAS STREET, SUITE 320, CLEARWATER, FL 33756 | No data |
| CHANGE OF MAILING ADDRESS | 1999-07-21 | 455 PINELLAS STREET, SUITE 320, CLEARWATER, FL 33756 | No data |
| NAME CHANGE AMENDMENT | 1999-03-11 | CARDIAC SURGICAL ASSOCIATES, INC. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1998-07-20 | 455 PINELLAS STREET, SUITE 320, CLEARWATER, FL 33756 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2005-04-09 |
| ANNUAL REPORT | 2004-07-09 |
| ANNUAL REPORT | 2003-04-17 |
| ANNUAL REPORT | 2002-05-02 |
| ANNUAL REPORT | 2001-04-18 |
| ANNUAL REPORT | 2000-04-19 |
| ANNUAL REPORT | 1999-07-21 |
| Name Change | 1999-03-11 |
| Reg. Agent Change | 1998-07-20 |
| Domestic Profit | 1998-01-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
