| Entity Name: | VERIMED HEALTH GROUP CARROLLWOOD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Aug 2005 (19 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 25 Jan 2016 (9 years ago) |
| Document Number: | L05000078183 |
| FEI/EIN Number | 203300793 |
| Address: | 8521 N. Armenia Ave, Tampa, FL, 33604, US |
| Mail Address: | 8521 N. Armenia Ave, Tampa, FL, 33604, US |
| ZIP code: | 33604 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336268788 | 2007-03-28 | 2016-06-07 | 8521 N ARMENIA AVE, TAMPA, FL, 336042540, US | 8521 N ARMENIA AVE, TAMPA, FL, 336042540, US | |||||||||||||||||||
|
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| Phone | +1 813-932-0996 |
| Fax | 8139320266 |
Authorized person
| Name | MRS. GINA PEREZ |
| Role | OFFICE MANAGER |
| Phone | 8139320996 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 0076006 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| REVELLO MARTIN | Agent | 26838 TANIC DRIVE, WESLEY CHAPEL, FL, 33544 |
| Name | Role |
|---|---|
| REVELLO HOLDINGS, LLC | Authorized Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000092544 | VERIMED HEALTH GROUP LAND O'LAKES | EXPIRED | 2012-09-20 | 2017-12-31 | No data | 8521 N. ARMENIA AVE., TAMPA, FL, 33604 |
| G12000092232 | VERIMED HEALTH GROUP CARROLLWOOD | EXPIRED | 2012-09-17 | 2017-12-31 | No data | 8521 N. ARMENIA AVENUE, TAMPA, FL, 33604 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-03-07 | 8521 N. Armenia Ave, Tampa, FL 33604 | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-07 | 8521 N. Armenia Ave, Tampa, FL 33604 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-03-07 | 26838 TANIC DRIVE, WESLEY CHAPEL, FL 33544 | No data |
| LC NAME CHANGE | 2016-01-25 | VERIMED HEALTH GROUP CARROLLWOOD, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| ANNUAL REPORT | 2023-04-06 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-24 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-03-07 |
| LC Name Change | 2016-01-25 |
| ANNUAL REPORT | 2016-01-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
