| Entity Name: | FLORIDA MEDICAL PSYCHOLOGY ASSOCIATES, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 24 May 2006 (19 years ago) |
| Document Number: | L06000053357 |
| FEI/EIN Number | 06-1779303 |
| Address: | 10910 Sheldon Road, TAMPA, FL 33626 |
| Mail Address: | 10910 SHELDON RD., TAMPA, FL 33626 |
| ZIP code: | 33626 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124123534 | 2006-09-13 | 2013-05-10 | 12167 W. LINEBAUGH AVE., TAMPA, FL, 33626, US | 12167 W. LINEBAUGH AVE., TAMPA, FL, 336264615, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-386-6800 |
| Fax | 8138911311 |
Authorized person
| Name | DR. MARIO S RODRIGUEZ |
| Role | MANAGER |
| Phone | 8133866800 |
Taxonomy
| Taxonomy Code | 103G00000X - Clinical Neuropsychologist |
| License Number | PY6274 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY6420 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY6792 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 103TH0100X - Health Service Psychologist |
| License Number | PY6377 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ, MARIO S | Agent | 14627 VILLAGE GLEN CIRCLE, TAMPA, FL 33618 |
| Name | Role | Address |
|---|---|---|
| KALY PSYCHOLOGICAL SERVICES, INC. | Managing Member | No data |
| FRIEDMAN & RODRIGUEZ PSYCHOLOGY ASSOCIATES | Managing Member | 14627 VILLAGE GLEN CIRCLE, TAMPA, FL 33618 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-22 | 10910 Sheldon Road, TAMPA, FL 33626 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-22 | 10910 Sheldon Road, TAMPA, FL 33626 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-04-15 | RODRIGUEZ, MARIO S | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-04-15 | 14627 VILLAGE GLEN CIRCLE, TAMPA, FL 33618 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-22 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-02-15 |
| ANNUAL REPORT | 2019-02-12 |
| ANNUAL REPORT | 2018-01-29 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-03-10 |
Date of last update: 28 Jan 2025
Sources: Florida Department of State
