| Entity Name: | FAMILY MEDICAL SPECIALISTS OF FLORIDA, PLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Apr 2007 (18 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 01 Oct 2020 (4 years ago) |
| Document Number: | L07000042212 |
| FEI/EIN Number | 208876699 |
| Address: | 1703 THONOTOSASSA ROAD, SUITE A, PLANT CITY, FL, 33563, US |
| Mail Address: | 1703 THONOTOSASSA ROAD, SUITE A, PLANT CITY, FL, 33563, US |
| ZIP code: | 33563 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427228998 | 2008-03-11 | 2023-05-12 | 1703 THONOTOSASSA RD, SUITE A, PLANT CITY, FL, 335634202, US | 1703 THONOTOSASSA RD, SUITE A, PLANT CITY, FL, 335634202, US | |||||||||||||||||||||||||
|
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| Phone | +1 813-567-5679 |
| Fax | 8135675686 |
Authorized person
| Name | DR. MICHAEL PAUL GIMNESS |
| Role | MEDICAL DIRECTOR |
| Phone | 8135675679 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME93084 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 274338800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Gimness Michael Paul Dr. | Agent | 2803 CLUBHOUSE DR, PLANT CITY, FL, 33566 |
| Name | Role | Address |
|---|---|---|
| Gimness Michael Paul Dr. | Manager | 2803 CLUBHOUSE DR, PLANT CITY, FL, 33566 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-24 | 2803 CLUBHOUSE DR, PLANT CITY, FL 33566 | No data |
| REINSTATEMENT | 2020-10-01 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-10-01 | Gimness, Michael Paul, Dr. | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-03 | 1703 THONOTOSASSA ROAD, SUITE A, PLANT CITY, FL 33563 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-03-20 | 1703 THONOTOSASSA ROAD, SUITE A, PLANT CITY, FL 33563 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-02 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-03-24 |
| REINSTATEMENT | 2020-10-01 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-29 |
| ANNUAL REPORT | 2017-04-06 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-03-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
