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VERIMED HEALTH GROUP SEMINOLE, LLC

Company Details

Entity Name: VERIMED HEALTH GROUP SEMINOLE, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 10 Jan 2011 (14 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 28 Jun 2019 (6 years ago)
Document Number: L11000003534
FEI/EIN Number 27-4509115
Address: 11200 SEMINOLE BLVD, SUITE 210, LARGO, FL 33778
Mail Address: 11200 SEMINOLE BLVD, SUITE 210, LARGO, FL 33778
ZIP code: 33778
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1295033785 2011-03-07 2018-04-30 9555 SEMINOLE BLVD, SUITE 205, SEMINOLE, FL, 337722562, US 9555 SEMINOLE BLVD, SUITE 205, SEMINOLE, FL, 337722562, US

Contacts

Phone +1 727-319-8900
Fax 7273198700

Authorized person

Name ANDREA MARIA LANE
Role ASSISTANT ADMINISTRATOR
Phone 7275770285

Taxonomy

Taxonomy Code 207R00000X - Internal Medicine Physician
License Number OS13602
State FL
Is Primary Yes

Agent

Name Role Address
REVELLO, MARTIN Agent 26838 TANIC DRIVE, WESLEY CHAPEL, FL 33544

Authorized Member

Name Role
VERIMED HEALTH GROUP HOLDINGS, LLC Authorized Member

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G12000092230 VERIMED HEALTH GROUP SEMINOLE EXPIRED 2012-09-17 2017-12-31 No data 26838 TANIC DRIVE, WESLEY CHAPEL, FL, 33544

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2023-03-13 11200 SEMINOLE BLVD, SUITE 210, LARGO, FL 33778 No data
CHANGE OF PRINCIPAL ADDRESS 2021-04-30 11200 SEMINOLE BLVD, SUITE 210, LARGO, FL 33778 No data
LC AMENDMENT 2019-06-28 No data No data
LC NAME CHANGE 2016-01-25 VERIMED HEALTH GROUP SEMINOLE, LLC No data
REGISTERED AGENT ADDRESS CHANGED 2012-04-18 26838 TANIC DRIVE, WESLEY CHAPEL, FL 33544 No data

Documents

Name Date
ANNUAL REPORT 2024-04-29
ANNUAL REPORT 2023-02-14
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: 24 Jan 2025

Sources: Florida Department of State