| Entity Name: | FLORIDA CENTER FOR GASTROENTEROLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Mar 2012 (13 years ago) |
| Document Number: | L12000044139 |
| FEI/EIN Number | NOT APPLICABLE |
| Mail Address: | 10920 Technology Terrace, Lakewood Ranch, FL, 34211, US |
| Address: | 13777 Belcher Rd S, Largo, FL, 33771-4003, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013096973 | 2006-11-03 | 2011-03-02 | 8250 BRYAN DAIRY RD, SUITE 200, LARGO, FL, 337771353, US | 8250 BRYAN DAIRY RD, SUITE 200, LARGO, FL, 337771353, US | |||||||||||||||||||||||||||
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| Phone | +1 727-544-1600 |
| Fax | 7275452555 |
Authorized person
| Name | ARTHUR BERMAN |
| Role | PRESIDENT |
| Phone | 7275441600 |
Taxonomy
| Taxonomy Code | 207RG0100X - Gastroenterology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 34315 |
| State | FL |
| Issuer | MEDICAID |
| Number | 264597100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DITOMASO ANTHONY M | Agent | 10920 Technology Terrace, Lakewood Ranch, FL, 34211 |
| Name | Role | Address |
|---|---|---|
| FLORIDA DIGESTIVE HEALTH SPECIALISTS, LLP | Managing Member | 10920 Technology Terrace, Lakewood Ranch, FL, 34211 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-03-03 | DITOMASO, ANTHONY M.D. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-12 | 13777 Belcher Rd S, Largo, FL 33771-4003 | No data |
| CHANGE OF MAILING ADDRESS | 2014-01-27 | 13777 Belcher Rd S, Largo, FL 33771-4003 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-27 | 10920 Technology Terrace, Lakewood Ranch, FL 34211 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-01-12 |
| ANNUAL REPORT | 2021-01-08 |
| ANNUAL REPORT | 2020-01-13 |
| ANNUAL REPORT | 2019-01-09 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-02-26 |
| ANNUAL REPORT | 2015-03-13 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
