| Entity Name: | PEDIATRIC & ADOLESCENT HEALTH ASSOCIATES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
PEDIATRIC & ADOLESCENT HEALTH ASSOCIATES LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 10 Oct 2013 (12 years ago) |
| Date of dissolution: | 01 Apr 2019 (6 years ago) |
| Last Event: | LC VOLUNTARY DISSOLUTION |
| Event Date Filed: | 01 Apr 2019 (6 years ago) |
| Document Number: | L13000143392 |
| FEI/EIN Number |
46-3850191
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 3709 W Hamilton Ave, Tampa, FL, 33614, US |
| Mail Address: | P O Box 42116, RICHMOND, VA, 23224, US |
| ZIP code: | 33614 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407250996 | 2014-10-13 | 2015-09-18 | PO BOX 270663, TAMPA, FL, 336880663, US | 3709 W HAMILTON AVE STE 4, TAMPA, FL, 336144015, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 813-515-7988 |
Authorized person
| Name | DR. TABASSUM SHAMIM |
| Role | MEDICAL DIRECTOR |
| Phone | 8608748374 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME115364 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010853700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHAMIM TABASSUM | Managing Member | P O BOX 42116, RICHMOND, VA, 23224 |
| SHAMIM TABASSUM | Agent | 3709 W HAMILTON AVE, STE 4, TAMPA, FL, 33614 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC VOLUNTARY DISSOLUTION | 2019-04-01 | - | - |
| CHANGE OF MAILING ADDRESS | 2019-04-01 | 3709 W Hamilton Ave, Ste 4, Tampa, FL 33614 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2016-04-14 | 3709 W Hamilton Ave, Ste 4, Tampa, FL 33614 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-14 | 3709 W HAMILTON AVE, STE 4, TAMPA, FL 33614 | - |
| LC AMENDMENT | 2015-03-25 | - | - |
| LC AMENDMENT | 2014-04-07 | - | - |
| Name | Date |
|---|---|
| LC Voluntary Dissolution | 2019-04-01 |
| ANNUAL REPORT | 2018-02-13 |
| ANNUAL REPORT | 2017-02-08 |
| ANNUAL REPORT | 2016-04-14 |
| ANNUAL REPORT | 2015-04-15 |
| LC Amendment | 2015-03-25 |
| ANNUAL REPORT | 2014-06-09 |
| LC Amendment | 2014-04-07 |
| Florida Limited Liability | 2013-10-10 |
Date of last update: 01 May 2025
Sources: Florida Department of State
