| Entity Name: | MAVERICK MEDICAL VENTURES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
MAVERICK MEDICAL VENTURES, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 16 Nov 1998 (26 years ago) |
| Date of dissolution: | 31 Mar 2011 (14 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 31 Mar 2011 (14 years ago) |
| Document Number: | P98000097428 |
| FEI/EIN Number |
522138397
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1409 WEST SWANN AVE., TAMPA, FL, 33606 |
| Mail Address: | 1409 WEST SWANN AVE., TAMPA, FL, 33606 |
| ZIP code: | 33606 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1548345234 | 2006-10-25 | 2020-08-22 | 3501 CATTLEMEN RD, SUITE C, SARASOTA, FL, 342326055, US | 3501 CATTLEMEN RD, SUITE C, SARASOTA, FL, 342326055, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 941-342-7667 |
| Fax | 9413427847 |
Authorized person
| Name | MR. DANIEL F BAFIA |
| Role | PRESIDENT |
| Phone | 9413427667 |
Taxonomy
| Taxonomy Code | 261QR0200X - Radiology Clinic/Center |
| License Number | HCC5056 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AETNA PROVIDER NUMBER |
| Number | 7180294 |
| State | FL |
| Issuer | FIRST HEALTH PROVIDER NUM |
| Number | 2013853 |
| State | FL |
| Issuer | STAYWELL PROVIDER |
| Number | 201694 |
| State | FL |
| Issuer | AMERIGROUP PROVIDER NUMBE |
| Number | 226521 |
| State | FL |
| Issuer | BCBS PROVIDER NUMBER |
| Number | V2973 |
| State | FL |
| Issuer | CCN PROVIDER NUMBER |
| Number | 5425850 |
| State | FL |
| Issuer | MEDICARE COMPLETE |
| Number | 82030 |
| State | FL |
| Issuer | OXFORD PROVIDER |
| Number | A2545060 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LUETGERT MIKE | Director | 1409 W. SWANN AVE., TAMPA, FL, 33606 |
| LUETGERT MIKE | President | 1409 W. SWANN AVE., TAMPA, FL, 33606 |
| BLAIR WILLARD A | Agent | 101 E. KENNEDY BLVD., TAMPA, FL, 33602 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2011-03-31 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2010-05-27 | 1409 WEST SWANN AVE., TAMPA, FL 33606 | - |
| REGISTERED AGENT NAME CHANGED | 2010-05-27 | BLAIR, WILLARD AESQ. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2010-05-27 | 101 E. KENNEDY BLVD., SUITE 2800, TAMPA, FL 33602 | - |
| CHANGE OF MAILING ADDRESS | 2010-05-27 | 1409 WEST SWANN AVE., TAMPA, FL 33606 | - |
| CANCEL ADM DISS/REV | 2004-10-20 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | - | - |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2011-03-31 |
| Reg. Agent Change | 2010-05-27 |
| ANNUAL REPORT | 2010-04-26 |
| ANNUAL REPORT | 2009-05-01 |
| ANNUAL REPORT | 2008-04-18 |
| ANNUAL REPORT | 2007-05-25 |
| ANNUAL REPORT | 2006-05-02 |
| ANNUAL REPORT | 2005-05-02 |
| ANNUAL REPORT | 2004-10-20 |
| ANNUAL REPORT | 2003-02-17 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
