| Entity Name: | ST. ANTHONY'S PROFESSIONAL BUILDINGS AND SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 27 Jun 1980 (45 years ago) |
| Document Number: | 753155 |
| FEI/EIN Number | 592018848 |
| Address: | 3001 W. DR MARTIN LUTHER KING JR BLVD., TAMPA, FL, 33607, US |
| Mail Address: | 3001 W. DR MARTIN LUTHER KING JR BLVD., TAMPA, FL, 33607, US |
| ZIP code: | 33607 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487908323 | 2012-10-30 | 2023-08-21 | 2995 DREW STREET, EAST BLDG 2ND FLOOR, CLEARWATER, FL, 33759, US | 620 10TH ST N STE 100, ST PETERSBURG, FL, 337051407, US | |||||||||||||||||||||||
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| Phone | +1 727-281-9390 |
| Fax | 8136352613 |
| Phone | +1 727-825-1045 |
Authorized person
| Name | TAMBLYN CUBERO |
| Role | CFO |
| Phone | 7273156974 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 019364701 |
| State | FL |
| Name | Role |
|---|---|
| BAYCARE HEALTH SYSTEM, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Bucciarelli Christopher Dr. | Vice President | 2985 Drew Street, Clearwater, FL, 33759 |
| Name | Role | Address |
|---|---|---|
| Haislip James | Treasurer | 2985 Drew Street, Clearwater, FL, 33759 |
| Name | Role | Address |
|---|---|---|
| Galdieri Lou | President | 2985 Drew Street, Clearwater, FL, 33759 |
| Name | Role | Address |
|---|---|---|
| Smith Scott | Director | 1200 Seventh Ave. North, St. Petersburg, FL, 33705 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000132315 | BAYCARE FITNESS CENTER | ACTIVE | 2021-10-01 | 2026-12-31 | No data | ATTENTION: LEGAL SERVICES, 2985 DREW STREET, CLEARWATER, FL, 33759 |
| G15000081250 | BAYCARE OUTPATIENT CENTER | ACTIVE | 2015-08-06 | 2025-12-31 | No data | 12780 RACE TRACK ROAD, TAMPA, FL, 33626 |
| G14000045062 | CARILLON WELLNESS CENTER | EXPIRED | 2014-05-06 | 2024-12-31 | No data | 900 CARILLON PARKWAY, ST. PETERSBURG, FL, 33716 |
| G12000083802 | ST. ANTHONY'S PET/CT CENTER | ACTIVE | 2012-08-24 | 2027-12-31 | No data | 900 CARILLON PARKWAY, ST. PETERSBURG, FL, 33716 |
| G09000161631 | BAYCARE OUTPATIENT IMAGING | EXPIRED | 2009-10-02 | 2024-12-31 | No data | 3890 TAMPA ROAD, PALM HARBOR, FL, 34684 |
| G09000161619 | BAYCARE OUTPATIENT IMAGING | EXPIRED | 2009-10-02 | 2014-12-31 | No data | 1200 7TH AVENUE NORTH, ST. PETERSBURG, FL, 33705 |
| G09000110492 | ST. ANTHONY'S OUTPATIENT CENTER AT CARILLON | EXPIRED | 2009-05-26 | 2024-12-31 | No data | 1200 7TH AVENUE NORTH, ST. PETERSBURG, FL, 33705 |
| G09000110491 | ST. ANTHONY'S IMAGING CENTER AT TYRONE | EXPIRED | 2009-05-26 | 2014-12-31 | No data | 3206 66TH STREET NORTH, ST. PETERSBURG, FL, 33701 |
| G09006900805 | GULFCOAST CANCER INSTITUTE | EXPIRED | 2009-01-06 | 2014-12-31 | No data | 1200 7TH AVENUE NORTH, ST. PETERSBURG, FL, 33705 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDED AND RESTATEDARTICLES | 2014-07-24 | No data | No data |
| AMENDMENT | 2012-06-08 | No data | No data |
| AMENDED AND RESTATEDARTICLES | 2002-12-16 | No data | No data |
| AMENDED AND RESTATEDARTICLES | 1997-12-02 | No data | No data |
| AMENDMENT | 1997-08-29 | No data | No data |
| AMENDED AND RESTATEDARTICLES | 1995-01-05 | No data | No data |
| CORPORATE MERGER NAME CHANGE | 1993-06-30 | ST. ANTHONY'S PROFESSIONAL BUILDINGS AND SERVICES, INC. | CORPORATE NAME CHANGE WAS A RESULT OF A MERGER. |
| CORPORATE MERGER | 1993-06-30 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. CORPORATE MERGER NUMBER 900000001659 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
