| Entity Name: | MEDICAL SPECIALIST ASSOCIATES OF FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 21 Jul 2004 (21 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | L04000054489 |
| FEI/EIN Number | 81-0656333 |
| Address: | 1240 S. FORT HARRISON AVENUE, CLEARWATER, FL 33756 |
| Mail Address: | 1240 S. FORT HARRISON AVENUE, CLEARWATER, FL 33756 |
| ZIP code: | 33756 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922023076 | 2006-07-12 | 2010-07-15 | PO BOX 277781, ATLANTA, GA, 303847781, US | 1064 KEENE RD, DUNEDIN, FL, 346986300, US | |||||||||||||||||||||||||||||
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| Phone | +1 813-852-3272 |
| Fax | 8138523233 |
| Phone | +1 727-733-9202 |
Authorized person
| Name | CARL TREMONTI |
| Role | CFO |
| Phone | 7278434599 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 277190000 |
| State | FL |
| Issuer | MEDICARE |
| Number | AB585 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARQUARDT, EMIL CJR | Agent | MACFARLANE FERGUSON & MCMULLEN, 625 COURT ST., STE. 200, CLEARWATER, FL 33756 |
| Name | Role |
|---|---|
| MORTON PLANT MEASE HEALTH SERVICES, INC. | Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2010-02-16 | MARQUARDT, EMIL CJR | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-02-16 | MACFARLANE FERGUSON & MCMULLEN, 625 COURT ST., STE. 200, CLEARWATER, FL 33756 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-02-18 |
| ANNUAL REPORT | 2010-02-16 |
| ANNUAL REPORT | 2009-05-05 |
| ANNUAL REPORT | 2008-03-06 |
| ANNUAL REPORT | 2007-04-16 |
| ANNUAL REPORT | 2006-04-17 |
| ANNUAL REPORT | 2005-07-06 |
| Florida Limited Liabilites | 2004-07-21 |
Date of last update: 05 Jan 2025
Sources: Florida Department of State
