| Entity Name: | VERIMED HEALTH GROUP CLEARWATER,LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Jun 2016 (9 years ago) |
| Document Number: | L16000124057 |
| FEI/EIN Number | 32-0500693 |
| Address: | 2515 COUNTRYSIDE BLVD, Clearwater, FL, 33763, US |
| Mail Address: | 2515 COUNTRYSIDE BLVD, Clearwater, FL, 33763, US |
| ZIP code: | 33763 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265988752 | 2016-08-25 | 2022-09-26 | 2515 COUNTRYSIDE BLVD STE H, CLEARWATER, FL, 337631603, US | 2515 COUNTRYSIDE BLVD STE H, CLEARWATER, FL, 337631603, US | |||||||||||||||||
|
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| Phone | +1 727-796-8600 |
| Fax | 8139320266 |
Authorized person
| Name | GINA PEREZ |
| Role | ADMINISTRATOR |
| Phone | 7277968600 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| REVELLO MARTIN | Agent | 26838 TANIC DRIVE, WESLEY CHAPEL, FL, 33544 |
| Name | Role |
|---|---|
| REVELLO HOLDINGS, LLC | Authorized Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-03-29 | 2515 COUNTRYSIDE BLVD, SUITE H, Clearwater, FL 33763 | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-29 | 2515 COUNTRYSIDE BLVD, SUITE H, Clearwater, FL 33763 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-03-07 | 26838 TANIC DRIVE, WESLEY CHAPEL, FL 33544 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-06 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-24 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-03-07 |
| Florida Limited Liability | 2016-06-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
