| Entity Name: | DALEY AND ASSOCIATES PRIMEMED OF TAMPA BAY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 May 2013 (12 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 06 Oct 2018 (6 years ago) |
| Document Number: | L13000064087 |
| FEI/EIN Number | 46-1728828 |
| Address: | 300 RIVERSIDE DRIVE, BRADENTON, FL, 34208, US |
| Mail Address: | 300 Riverside Dr, Bradenton, FL, 34208, US |
| ZIP code: | 34208 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962843029 | 2013-07-17 | 2013-07-17 | 300 RIVERSIDE DR E, STE 2600, BRADENTON, FL, 342081008, US | 300 RIVERSIDE DR E, STE 2600, BRADENTON, FL, 342081008, US | |||||||||||||||||||||||||
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| Phone | +1 941-251-4933 |
| Fax | 9412514934 |
Authorized person
| Name | JOSIE A. WALTERS |
| Role | MPM SPECIALIST |
| Phone | 3022332532 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME92581 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 273870800 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DALEY AND ASSOCIATES PRIMEMED OF TAMPA BAY 401(K) PLAN | 2023 | 461728828 | 2024-10-02 | DALEY AND ASSOCIATES PRIMEMED OF TAMPA BAY, LLC | 4 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| DALEY ANDREW C | Agent | 300 Riverside Dr, Bradenton, FL, 34208 |
| Name | Role | Address |
|---|---|---|
| DALEY ANDREW C | Managing Member | 300 Riverside Dr, Bradenton, FL, 34208 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2018-10-06 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2017-04-28 | 300 RIVERSIDE DRIVE, SUITE 1000, BRADENTON, FL 34208 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-28 | 300 Riverside Dr, 1000, Bradenton, FL 34208 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-07-25 | 300 RIVERSIDE DRIVE, SUITE 1000, BRADENTON, FL 34208 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-02-04 | DALEY, ANDREW C | No data |
| REINSTATEMENT | 2016-02-04 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-16 |
| ANNUAL REPORT | 2024-01-26 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-03-12 |
| ANNUAL REPORT | 2020-07-20 |
| ANNUAL REPORT | 2019-02-13 |
| REINSTATEMENT | 2018-10-06 |
| ANNUAL REPORT | 2017-04-28 |
| REINSTATEMENT | 2016-02-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
