| Entity Name: | VERIMED HEALTH GROUP NORTH TAMPA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Mar 2012 (13 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 31 Jan 2017 (8 years ago) |
| Document Number: | L12000044120 |
| FEI/EIN Number | 45-4909266 |
| Address: | 3000 MEDICAL PARK DR, TAMPA, FL, 33613, US |
| Mail Address: | 3000 MEDICAL PARK DR, TAMPA, FL, 33613, US |
| ZIP code: | 33613 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881940914 | 2012-07-26 | 2023-01-24 | 3000 MEDICAL PARK DR, SUITE 450, TAMPA, FL, 336134680, US | 3000 MEDICAL PARK DR, SUITE 450, TAMPA, FL, 336134680, US | |||||||||||||||||||
|
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| Phone | +1 813-972-5420 |
| Fax | 8139772021 |
Authorized person
| Name | MS. CARLA QUINONES |
| Role | ADMINISTRATOR |
| Phone | 8139725420 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME101151 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Revello Martin | Agent | 26838 TANIC DRIVE, WESLEY CHAPEL, FL, 33544 |
| Name | Role |
|---|---|
| REVELLO HOLDINGS, LLC | Authorized Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-03-13 | 3000 MEDICAL PARK DR, SUITE 450, TAMPA, FL 33613 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-30 | 3000 MEDICAL PARK DR, SUITE 450, TAMPA, FL 33613 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-03-07 | 26838 TANIC DRIVE, WESLEY CHAPEL, FL 33544 | No data |
| LC NAME CHANGE | 2017-01-31 | VERIMED HEALTH GROUP NORTH TAMPA, LLC | No data |
| REGISTERED AGENT NAME CHANGED | 2016-04-29 | Revello, Martin | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| ANNUAL REPORT | 2023-02-14 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-03-07 |
| LC Name Change | 2017-01-31 |
| ANNUAL REPORT | 2016-04-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
