Entity Name: | TAMPA BAY PEDIATRICS, L.L.C. |
Jurisdiction: | FLORIDA |
Filing Type: | Florida Limited Liability Company |
Status: | Active |
Date Filed: | 10 Jul 2006 (19 years ago) |
Document Number: | L06000068743 |
FEI/EIN Number | 84-1714182 |
Address: | 9420 lazy ln,, suite e-3, tampa, FL 33614 |
Mail Address: | PO BOX 152682, TAMPA, FL 33684 |
ZIP code: | 33614 |
County: | Hillsborough |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1083877047 | 2008-07-09 | 2023-03-07 | PO BOX 152682, TAMPA, FL, 336842682, US | 2302 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL, 336076406, US | |||||||||||||||||||||||||||||||||||||||||||
|
Phone | +1 813-743-7879 |
Fax | 8139265358 |
Authorized person
Name | DR. CARLOS M CARTAYA |
Role | OWNER |
Phone | 8137437879 |
Taxonomy
Taxonomy Code | 208000000X - Pediatrics Physician |
License Number | ME84690 |
State | FL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | AVMED |
Number | 284838 |
State | FL |
Issuer | AETNA |
Number | 7189416 |
State | FL |
Issuer | BCBS |
Number | 03286 |
State | FL |
Issuer | CIGNA |
Number | 4137152 |
State | FL |
Name | Role | Address |
---|---|---|
CARTAYA, LARA | Agent | 3906 FLOYD RD., TAMPA, FL 33618 |
Name | Role | Address |
---|---|---|
CARTAYA, CARLOS MMD | Manager | 3906 FLOYD RD., TAMPA, FL 33618 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF PRINCIPAL ADDRESS | 2016-06-17 | 9420 lazy ln,, suite e-3, tampa, FL 33614 | No data |
REGISTERED AGENT ADDRESS CHANGED | 2010-03-29 | 3906 FLOYD RD., TAMPA, FL 33618 | No data |
CHANGE OF MAILING ADDRESS | 2008-07-02 | 9420 lazy ln,, suite e-3, tampa, FL 33614 | No data |
Name | Date |
---|---|
ANNUAL REPORT | 2024-04-09 |
ANNUAL REPORT | 2023-04-21 |
ANNUAL REPORT | 2022-03-30 |
ANNUAL REPORT | 2021-04-14 |
ANNUAL REPORT | 2020-02-27 |
ANNUAL REPORT | 2019-03-27 |
ANNUAL REPORT | 2018-03-26 |
ANNUAL REPORT | 2017-03-21 |
ANNUAL REPORT | 2016-03-15 |
ANNUAL REPORT | 2015-02-26 |
Date of last update: 27 Jan 2025
Sources: Florida Department of State