| Entity Name: | PRIMECARE SOUTH TAMPA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 25 Jul 2007 (18 years ago) |
| Date of dissolution: | 25 Jan 2016 (9 years ago) |
| Last Event: | LC VOLUNTARY DISSOLUTION |
| Event Date Filed: | 25 Jan 2016 (9 years ago) |
| Document Number: | L07000076806 |
| FEI/EIN Number | 260585533 |
| Mail Address: | 26838 TANIC DRIVE, WESLEY CHAPEL, FL, 33544 |
| Address: | 2919 SWANN AVE, STE 400A, TAMPA, FL, 33609 |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538357454 | 2007-10-04 | 2007-10-04 | 2919 W SWANN AVE, SUITE 400A, TAMPA, FL, 336094038, US | 2919 W SWANN AVE, SUITE 400A, TAMPA, FL, 336094038, US | |||||||||||||
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| Phone | +1 813-871-2959 |
Authorized person
| Name | GLADYMAR VELEZ |
| Role | PRACTICE ADMINISTRATOR |
| Phone | 8138712959 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| REVELLO MARTIN | Agent | 26838 TANIC DRIVE, WESLEY CHAPEL, FL, 33544 |
| Name | Role | Address |
|---|---|---|
| REVELLO MARTIN | Manager | 26838 TANIC DRIVE, WESLEY CHAPEL, FL, 33544 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC VOLUNTARY DISSOLUTION | 2016-01-25 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2012-04-17 | 2919 SWANN AVE, STE 400A, TAMPA, FL 33609 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-17 | 26838 TANIC DRIVE, WESLEY CHAPEL, FL 33544 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-03-30 | REVELLO, MARTIN | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-30 | 2919 SWANN AVE, STE 400A, TAMPA, FL 33609 | No data |
| LC AMENDED AND RESTATED ARTICLES | 2007-08-23 | No data | No data |
| Name | Date |
|---|---|
| LC Voluntary Dissolution | 2016-01-25 |
| ANNUAL REPORT | 2015-04-28 |
| ANNUAL REPORT | 2014-04-23 |
| ANNUAL REPORT | 2013-04-24 |
| ANNUAL REPORT | 2012-04-17 |
| ANNUAL REPORT | 2011-03-30 |
| ANNUAL REPORT | 2010-04-29 |
| ANNUAL REPORT | 2009-04-30 |
| ANNUAL REPORT | 2008-07-08 |
| Reg. Agent Change | 2008-03-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
