| Entity Name: | VERIMED HEALTH GROUP PINELLAS PARK, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 24 Apr 2009 (16 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 28 Jun 2019 (6 years ago) |
| Document Number: | L09000040230 |
| FEI/EIN Number | 26-4756214 |
| Address: | 12450 ROOSEVELT BLVD. N, SUITE 308, ST. PETERSBURG, FL 33716 |
| Mail Address: | 12450 ROOSEVELT BLVD. N, SUITE 308, ST. PETERSBURG, FL 33716 |
| ZIP code: | 33716 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043441546 | 2009-07-31 | 2023-01-22 | 12450 ROOSEVELT BLVD N, ST PETERSBURG, FL, 337161902, US | 12450 ROOSEVELT BLVD N STE 308, ST PETERSBURG, FL, 337161902, US | |||||||||||||||||||
|
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| Phone | +1 727-577-0285 |
| Fax | 7275773870 |
Authorized person
| Name | JULISSA ORTIZ |
| Role | ASSISTANT ADMINISTRATOR |
| Phone | 7275770285 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | OS8908 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| REVELLO, MARTIN | Agent | 26838 TANIC DRIVE, WESLEY CHAPEL, FL 33544 |
| Name | Role |
|---|---|
| VERIMED HEALTH GROUP HOLDINGS, LLC | Authorized Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000081509 | VERIMED HEALTH GROUP PINELLAS PARK | EXPIRED | 2012-08-16 | 2017-12-31 | No data | 26838 TANIC DRIVE, WESLEY CHAPEL, FL, 33544 |
| G12000076035 | VERMED HEALTH GROUP PINELLAS PARK | EXPIRED | 2012-07-30 | 2017-12-31 | No data | 26838 TANIC DRIVE, WESLEY CHAPEL, FL, 33544 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-06-26 | 12450 ROOSEVELT BLVD. N, SUITE 308, ST. PETERSBURG, FL 33716 | No data |
| CHANGE OF MAILING ADDRESS | 2023-06-26 | 12450 ROOSEVELT BLVD. N, SUITE 308, ST. PETERSBURG, FL 33716 | No data |
| LC AMENDMENT | 2019-06-28 | No data | No data |
| LC NAME CHANGE | 2016-01-25 | VERMED HEALTH GROUP PINELLAS PARK, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-18 | 26838 TANIC DRIVE, WESLEY CHAPEL, FL 33544 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-03-17 | REVELLO, MARTIN | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-06 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-30 |
| LC Amendment | 2019-06-28 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-04-14 |
| LC Name Change | 2016-01-25 |
Date of last update: 25 Jan 2025
Sources: Florida Department of State
