| Entity Name: | MPM CARDIOLOGY SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 01 Dec 2011 (13 years ago) |
| Date of dissolution: | 28 Dec 2017 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 28 Dec 2017 (7 years ago) |
| Document Number: | L11000135832 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 300 S. PARK PLACE BLVD., SUITE 180, CLEARWATER, FL, 33759, US |
| Mail Address: | 300 S. PARK PLACE BLVD., SUITE 180, CLEARWATER, FL, 33759, US |
| ZIP code: | 33759 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114295698 | 2011-12-12 | 2015-06-16 | PO BOX 9200, PALM HARBOR, FL, 346829200, US | 300 PARK PLACE BLVD, SUITE 170, CLEARWATER, FL, 337594932, US | |||||||||||||||||||||||||
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| Phone | +1 727-789-3179 |
| Fax | 7277811315 |
| Phone | +1 727-532-0002 |
| Fax | 7272664928 |
Authorized person
| Name | MR. GLENN D. WATERS |
| Role | PRESIDENT |
| Phone | 7275321355 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008209100 |
| State | FL |
| Name | Role |
|---|---|
| BAYCARE HEALTH SYSTEM, INC. | Agent |
| Name | Role |
|---|---|
| MORTON PLANT MEASE HEALTH SERVICES, INC. | Authorized Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2017-12-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-03-02 | BAYCARE HEALTH SYSTEM, INC. | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-23 | 300 S. PARK PLACE BLVD., SUITE 180, CLEARWATER, FL 33759 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-23 | 300 S. PARK PLACE BLVD., SUITE 180, CLEARWATER, FL 33759 | No data |
| LC AMENDMENT | 2014-12-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-04-21 | ATTENTION: LEGAL SERVICES DEPARTMENT, 2985 DREW STREET, CLEARWATER, FL 33759 | No data |
| LC AMENDMENT AND NAME CHANGE | 2012-12-04 | MPM CARDIOLOGY SERVICES, LLC | No data |
| LC NAME CHANGE | 2011-12-23 | MPMS MEDICAL SERVICES, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-03-20 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-04-23 |
| LC Amendment | 2014-12-24 |
| ANNUAL REPORT | 2014-04-21 |
| ANNUAL REPORT | 2013-04-29 |
| LC Amendment and Name Change | 2012-12-04 |
| ANNUAL REPORT | 2012-03-12 |
| LC Name Change | 2011-12-23 |
| Florida Limited Liability | 2011-12-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
