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  5. PINELLAS COUNTY PRIMARY CARE AND HOSPITALISTS, PLLC

PINELLAS COUNTY PRIMARY CARE AND HOSPITALISTS, PLLC

Company Details

Entity Name: PINELLAS COUNTY PRIMARY CARE AND HOSPITALISTS, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 13 Jul 2015 (10 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 10 Nov 2015 (9 years ago)
Document Number: L15000116997
FEI/EIN Number 474594025
Mail Address: 1007 Jeffords St, Clearwater, FL, 33756, US
Address: 516 Lakeview Rd, Clearwater, FL, 33756, US
ZIP code: 33756
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1790154714 2015-09-21 2022-07-14 1007 JEFFORDS ST STE 101, CLEARWATER, FL, 337564082, US 516 LAKEVIEW RD, SUITE#4, CLEARWATER, FL, 337563302, US

Contacts
Phone +1 727-461-7908
Fax 7272235269

Authorized person
Name KELLY CARLSON
Role PRACTICE MANAGER
Phone 7274440407

Taxonomy
Taxonomy Code 207R00000X - Internal Medicine Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 015819900
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PCPCAH 401(K) PLAN 2023 474594025 2024-03-29 PINELLAS COUNTY PRIMARY CARE AND HOSPITALISTS, PLLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 7274617908
Plan sponsor’s address 516 LAKEVIEW RD, SUITE 4, CLEARWATER, FL, 33756
PCPCAH 401(K) PLAN 2022 474594025 2023-04-25 PINELLAS COUNTY PRIMARY CARE AND HOSPITALISTS, PLLC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 7274617908
Plan sponsor’s address 516 LAKEVIEW RD, SUITE 4, CLEARWATER, FL, 33756
PCPCAH 401(K) PLAN 2021 474594025 2022-07-15 PINELLAS COUNTY PRIMARY CARE AND HOSPITALISTS, PLLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 7274617908
Plan sponsor’s address 516 LAKEVIEW RD, SUITE 4, CLEARWATER, FL, 33756
PCPCAH 401(K) PLAN 2020 474594025 2021-03-17 PINELLAS COUNTY PRIMARY CARE AND HOSPITALISTS, PLLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 7274617908
Plan sponsor’s address 516 LAKEVIEW RD, SUITE 4, CLEARWATER, FL, 33756
PCPCAH 401(K) PLAN 2019 474594025 2020-04-14 PINELLAS COUNTY PRIMARY CARE AND HOSPITALISTS, PLLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 7274617908
Plan sponsor’s address 516 LAKEVIEW RD, SUITE 4, CLEARWATER, FL, 33756
PCPCAH 401(K) PLAN 2018 474594025 2019-03-01 PINELLAS COUNTY PRIMARY CARE AND HOSPITALISTS, PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 7274617908
Plan sponsor’s address 516 LAKEVIEW RD, SUITE 4, CLEARWATER, FL, 33756

Signature of
Role Plan administrator
Date 2019-03-01
Name of individual signing HOWARD FEINGOLD
Valid signature Filed with authorized/valid electronic signature
PCPCAH 401(K) PLAN 2017 474594025 2018-03-21 PINELLAS COUNTY PRIMARY CARE AND HOSPITALISTS, PLLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 7274617908
Plan sponsor’s address 516 LAKEVIEW RD, SUITE 4, CLEARWATER, FL, 33756

Signature of
Role Plan administrator
Date 2018-03-21
Name of individual signing HOWARD FEINGOLD
Valid signature Filed with authorized/valid electronic signature
PCPCAH 401(K) PLAN 2016 474594025 2017-10-11 PINELLAS COUNTY PRIMARY CARE AND HOSPITALISTS, PLLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 7274617908
Plan sponsor’s address 516 LAKEVIEW RD, SUITE 4, CLEARWATER, FL, 33756

Signature of
Role Plan administrator
Date 2017-10-11
Name of individual signing HOWARD FEINGOLD
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WANGER MICHAEL PMD Agent 516 Lakeview Rd, Clearwater, FL, 33756

Managing Member

Name Role Address
WANGER MICHAEL Managing Member 516 Lakeview Rd, Clearwater, FL, 33756
FEINGOLD HOWARD Managing Member 516 LAKEVIEW RD SUITE 4, CLEARWATER, FL, 33756
Carlson Kelly Managing Member 1007 Jeffords St, Clearwater, FL, 33756

Prac

Name Role Address
Carlson Kelly Prac 516 Lakeview Rd, Clearwater, FL, 33756

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2023-01-11 516 Lakeview Rd, Bldg 4, Clearwater, FL 33756 No data
REGISTERED AGENT ADDRESS CHANGED 2017-01-09 516 Lakeview Rd, Bldg 4, Clearwater, FL 33756 No data
CHANGE OF PRINCIPAL ADDRESS 2016-04-28 516 Lakeview Rd, Bldg 4, Clearwater, FL 33756 No data
LC AMENDMENT 2015-11-10 No data No data

Documents

Name Date
ANNUAL REPORT 2025-01-15
ANNUAL REPORT 2024-01-29
ANNUAL REPORT 2023-01-11
ANNUAL REPORT 2022-01-18
ANNUAL REPORT 2021-01-27
ANNUAL REPORT 2020-01-02
ANNUAL REPORT 2019-01-07
ANNUAL REPORT 2018-01-16
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-04-28

Related by officers

FEINGOLD HOWARD

TRIPLE-B FARMS, LLC TANYABIO LLC GOTHAM PERSONNEL OF FLORIDA, LLC GOTHAM PERSONNEL, LLC

WANGER MICHAEL PMD

MICHAEL P. WANGER, M.D., PLLC

Related by address

1007 Jeffords St, Clearwater, FL, 33756, US

ANNETTE HILS MD PA

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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