| Entity Name: | NEW TAMPA MEDICAL CLINIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 May 2004 (21 years ago) |
| Document Number: | L04000034803 |
| FEI/EIN Number | 562458496 |
| Address: | 20431 BRUCE B. DOWNS BLVD, TAMPA, FL, 33647 |
| Mail Address: | 20431 BRUCE B. DOWNS BLVD, TAMPA, FL, 33647 |
| ZIP code: | 33647 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962686931 | 2007-12-26 | 2013-04-19 | 20431 BRUCE B DOWNS BLVD, TAMPA, FL, 336472759, US | 20431 BRUCE B DOWNS BLVD, TAMPA, FL, 336472759, US | |||||||||||||||||||
|
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| Phone | +1 813-994-9995 |
| Fax | 8139948019 |
Authorized person
| Name | DR. SUVARNA NOMULA |
| Role | CEO |
| Phone | 8139949995 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME85978 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| NOMULA JEEVAN | Agent | 8317 GOLDEN PRAIRIE DR, TAMPA, FL, 33647 |
| Name | Role | Address |
|---|---|---|
| NOMULA SUVARNA | Managing Member | 8317 GOLDEN PRAIRIE DRIVE, TAMPA, FL, 33647 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2012-01-04 | 20431 BRUCE B. DOWNS BLVD, TAMPA, FL 33647 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-02-16 | NOMULA, JEEVAN | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-02-16 | 8317 GOLDEN PRAIRIE DR, TAMPA, FL 33647 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-01-06 | 20431 BRUCE B. DOWNS BLVD, TAMPA, FL 33647 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-17 |
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-02-08 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-03-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
