| 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 | |||||||||||||||||||||||||||||||||||||||||||||||
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| 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
