| Entity Name: | TAMPA BAY HEALTH ALLIANCE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 13 May 2016 (9 years ago) |
| Document Number: | L16000094519 |
| FEI/EIN Number | 81-2742352 |
| Address: | 12901 Bruce B. Downs Blvd, MDC 02, CMS 3rd FfL, TAMPA, FL 33612 |
| Mail Address: | 12901 Bruce B. Downs Blvd, MDC 02, CMS 3rd FL, TAMPA, FL 33612 |
| ZIP code: | 33612 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649719238 | 2017-02-16 | 2017-02-16 | 3500 E FLETCHER AVE, SUITE 400, TAMPA, FL, 336134708, US | 3500 E FLETCHER AVE, SUITE 400, TAMPA, FL, 336134708, US | |||||||||||||
|
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| Phone | +1 813-974-4173 |
Authorized person
| Name | DANIEL BRIAN VUKMER |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 4126516015 |
Taxonomy
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Vukmer, Daniel B | Agent | 13101 BRUCE B. DOWNS BLVD., 3RD FLOOR, TAMPA, FL 33612 |
| Name | Role | Address |
|---|---|---|
| Vukmer, Daniel Brian | Chief Executive Officer | 3500 E. FLETCHER AVENUE, SUITE 400 TAMPA, FL 33613 |
| Name | Role | Address |
|---|---|---|
| Ferrelli, Richard | Manager | 3500 E. FLETCHER AVENUE, SUITE 400 TAMPA, FL 33613 |
| Kulak, Kara, Dr. | Manager | 3500 E. FLETCHER AVENUE, SUITE 400 TAMPA, FL 33613 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-11 | 12901 Bruce B. Downs Blvd, MDC 02, CMS 3rd FfL, TAMPA, FL 33612 | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-11 | 12901 Bruce B. Downs Blvd, MDC 02, CMS 3rd FfL, TAMPA, FL 33612 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-05-16 | Vukmer, Daniel B | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-02 |
| ANNUAL REPORT | 2023-06-09 |
| ANNUAL REPORT | 2022-03-16 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-03-11 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-05-16 |
| ANNUAL REPORT | 2017-02-13 |
| Florida Limited Liability | 2016-05-13 |
Date of last update: 19 Feb 2025
Sources: Florida Department of State
