Entity Name: | DOCTORS MEDICAL CLINICS OF TAMPA, LLC |
Jurisdiction: | FLORIDA |
Filing Type: | Florida Limited Liability Co. |
Status: | Active |
Date Filed: | 13 Jan 2010 (15 years ago) |
Last Event: | LC AMENDMENT |
Event Date Filed: | 23 Jun 2014 (11 years ago) |
Document Number: | L10000004766 |
FEI/EIN Number | 271664247 |
Address: | 10770 N. 46th Street, Unit B-300, TAMPA, FL, 33617, US |
Mail Address: | 10770 N. 46th Street, Unit B-300, TAMPA, FL, 33617, US |
ZIP code: | 33617 |
County: | Hillsborough |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1528364882 | 2011-02-03 | 2018-05-02 | 10770 N 46TH ST STE B300, TAMPA, FL, 336173488, US | 10770 N 46TH ST STE B300, TAMPA, FL, 336173488, US | |||||||||||||||||||||||||||||||||||||||||||||||
|
Phone | +1 813-988-8380 |
Fax | 8139888423 |
Authorized person
Name | MR. WISDOM K DARKO |
Role | MANAGER/OWNER |
Phone | 8139888380 |
Taxonomy
Taxonomy Code | 261Q00000X - Clinic/Center |
License Number | HCC8997 |
State | FL |
Is Primary | No |
Taxonomy Code | 261QP3300X - Pain Clinic/Center |
License Number | PMC1035 |
State | FL |
Is Primary | Yes |
Taxonomy Code | 302R00000X - Health Maintenance Organization |
License Number | HCC8997 |
State | FL |
Is Primary | No |
Other Provider Identifiers
Issuer | AHCA |
Number | HCC8997 |
State | FL |
Issuer | MEDICARE |
Number | EZ293A |
State | FL |
Name | Role | Address |
---|---|---|
DARKO WISDOM K | Agent | 11023 Ancient Futures Dr, TAMPA, FL, 33647 |
Name | Role | Address |
---|---|---|
DARKO WISDOM K | Managing Member | 11023 ANCIENT FUTURE DR, TAMPA, FL, 33647 |
Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
---|---|---|---|---|---|---|
G24000128635 | DOCMED SUPPLY & SERVICES | ACTIVE | 2024-10-18 | 2029-12-31 | No data | 10770 N. 46TH ST, SUITE B-300, TAMPA, FL, 33617 |
G22000011060 | DOCMED SUPPLY & SERVICES | ACTIVE | 2022-01-26 | 2027-12-31 | No data | 10770 N 46TH ST., SUITE B-300, TAMPA, FL, 33617 |
G18000030609 | DOCMED SUPPLY & SERVICES | EXPIRED | 2018-03-05 | 2023-12-31 | No data | 10770 N 46TH STR, SUITE B-300, TAMPA, FL, 33617 |
G12000003507 | DOCMED SUPPLY & SERVICES | EXPIRED | 2012-01-10 | 2017-12-31 | No data | 4941 EAST BUSCH BLVD, SUITE # 210, TAMPA, FL, 3361-7 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF MAILING ADDRESS | 2024-03-01 | 10770 N. 46th Street, Unit B-300, TAMPA, FL 33617 | No data |
CHANGE OF PRINCIPAL ADDRESS | 2016-01-04 | 10770 N. 46th Street, Unit B-300, TAMPA, FL 33617 | No data |
REGISTERED AGENT ADDRESS CHANGED | 2016-01-04 | 11023 Ancient Futures Dr, TAMPA, FL 33647 | No data |
LC AMENDMENT | 2014-06-23 | No data | No data |
LC AMENDMENT | 2012-08-22 | No data | No data |
Name | Date |
---|---|
ANNUAL REPORT | 2024-03-01 |
ANNUAL REPORT | 2023-02-20 |
ANNUAL REPORT | 2022-03-18 |
ANNUAL REPORT | 2021-02-05 |
ANNUAL REPORT | 2020-02-25 |
ANNUAL REPORT | 2019-03-05 |
ANNUAL REPORT | 2018-03-05 |
ANNUAL REPORT | 2017-03-24 |
ANNUAL REPORT | 2016-01-04 |
ANNUAL REPORT | 2015-04-22 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State