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TAMPA INTERVENTIONAL SPINE PHYSICIANS LLC

Company Details

Entity Name: TAMPA INTERVENTIONAL SPINE PHYSICIANS LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Inactive
Date Filed: 12 Sep 2011 (13 years ago)
Date of dissolution: 24 May 2013 (12 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 24 May 2013 (12 years ago)
Document Number: L11000103591
FEI/EIN Number 45-3205331
Address: 1000 W KENNEDY BLVD, SUITE 201, TAMPA, FL 33606
Mail Address: 701 S Howard Ave., SUITE 106312, TAMPA, FL 33606
ZIP code: 33606
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1508101296 2012-12-06 2012-12-07 1000 W KENNEDY BLVD, SUITE 201, TAMPA, FL, 336061940, US 1000 W KENNEDY BLVD, SUITE 201, TAMPA, FL, 336061940, US

Contacts

Phone +1 813-258-2225
Fax 8132588118

Authorized person

Name KORTNI FLYNN
Role OWNER
Phone 9897141839

Taxonomy

Taxonomy Code 207LP2900X - Pain Medicine (Anesthesiology) Physician
License Number 98264
State FL
Is Primary No
Taxonomy Code 207RA0401X - Addiction Medicine (Internal Medicine) Physician
License Number 105149
State FL
Is Primary No
Taxonomy Code 208VP0014X - Interventional Pain Medicine Physician
License Number 105149
State FL
Is Primary Yes

Agent

Name Role Address
FLYNN, KORTNI Agent 1000 W KENNEDY BLVD, SUITE 201, TAMPA, FL 33606

Managing Member

Name Role Address
FLYNN, KORTNI Managing Member 701 S Howard Ave., Suite 106312 TAMPA, FL 33606
VU, DAMON Managing Member 701 S. Howard Ave., Suite 106312 TAMPA, FL 33606

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2013-05-24 No data No data
CHANGE OF MAILING ADDRESS 2013-02-14 1000 W KENNEDY BLVD, SUITE 201, TAMPA, FL 33606 No data
REGISTERED AGENT ADDRESS CHANGED 2012-05-14 1000 W KENNEDY BLVD, SUITE 201, TAMPA, FL 33606 No data
CHANGE OF PRINCIPAL ADDRESS 2012-05-11 1000 W KENNEDY BLVD, SUITE 201, TAMPA, FL 33606 No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2013-05-24
ANNUAL REPORT 2013-02-14
Reg. Agent Change 2012-05-14
ANNUAL REPORT 2012-02-08
Florida Limited Liability 2011-09-12

Date of last update: 24 Jan 2025

Sources: Florida Department of State