| Entity Name: | HILLSBOROUGH MEDICAL ASSOCIATES, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Jul 2007 (18 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 08 Nov 2024 (3 months ago) |
| Document Number: | L07000072624 |
| FEI/EIN Number | 320223562 |
| Mail Address: | 3820 TAMPA ROAD, SUITE 202, PALM HARBOR, FL, 34684 |
| Address: | 7519 PAULA DR, TAMPA, FL, 33615 |
| ZIP code: | 33615 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568621019 | 2008-06-09 | 2009-03-24 | 7519 PAULA DR, TAMPA, FL, 336154113, US | 7519 PAULA DR, TAMPA, FL, 336154113, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 813-884-1478 |
| Fax | 8138841798 |
Authorized person
| Name | DEBBIE A THOMAS |
| Role | OFFICE MANAGER |
| Phone | 8138841478 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME47065 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE SHIELD |
| Number | 33864 |
| State | FL |
| Issuer | MEDICAID |
| Number | 046784700 |
| State | FL |
| Name | Role |
|---|---|
| CHESTNUT BUSINESS SERVICES, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| HPA Manager, LLC | Auth | 108 Lakeland Ave, Dover, DE, 19901 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-12-03 | 311 PARK PLACE BOULEVARD, SUITE 300, CLEARWATER, FL 33759 | No data |
| REINSTATEMENT | 2024-11-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-05-01 | Chestnut Business Services, LLC | No data |
| CHANGE OF MAILING ADDRESS | 2012-04-20 | 7519 PAULA DR, TAMPA, FL 33615 | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-11-08 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-07-15 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-03-23 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-14 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-04-03 |
| ANNUAL REPORT | 2015-02-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
