| Entity Name: | SOUTH TAMPA DERMATOLOGY, PL |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 May 2004 (21 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 27 Sep 2004 (20 years ago) |
| Document Number: | L04000033234 |
| FEI/EIN Number | 201114886 |
| Address: | 2605 W. SWANN AVE., SUITE #300, TAMPA, FL, 33609, US |
| Mail Address: | 2605 W. SWANN AVE., SUITE #300, TAMPA, FL, 33609, US |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467568477 | 2006-08-22 | 2020-08-22 | 2605 W SWANN AVE, SUITE #300, TAMPA, FL, 336094039, US | 2605 W SWANN AVE, SUITE #300, TAMPA, FL, 336094039, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 813-872-9551 |
| Fax | 8138729554 |
Authorized person
| Name | MR. JAMES G FLYNN |
| Role | TREASURER |
| Phone | 8138729551 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME66332 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 26291A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FLYNN JAMES G | Agent | 2605 W. SWANN AVE, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| FLYNN JAMES G | Manager | 2605 W. SWANN AVE. #300, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| FLYNN LINDA J | Managing Member | 2605 W. SWANN AVE. #300, TAMPA, FL, 33609 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2017-02-16 | FLYNN, JAMES G | No data |
| CHANGE OF MAILING ADDRESS | 2009-03-19 | 2605 W. SWANN AVE., SUITE #300, TAMPA, FL 33609 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-03-21 | 2605 W. SWANN AVE, #300, TAMPA, FL 33609 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-04-29 | 2605 W. SWANN AVE., SUITE #300, TAMPA, FL 33609 | No data |
| AMENDMENT | 2004-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-02-13 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-03-08 |
| ANNUAL REPORT | 2019-02-24 |
| ANNUAL REPORT | 2018-02-21 |
| ANNUAL REPORT | 2017-02-16 |
| ANNUAL REPORT | 2016-03-03 |
| ANNUAL REPORT | 2015-02-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
