| Entity Name: | FLORIDA FAMILY PRACTICE & URGENT CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 11 Jul 2016 (9 years ago) |
| Date of dissolution: | 28 Apr 2023 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 28 Apr 2023 (2 years ago) |
| Document Number: | L16000130448 |
| FEI/EIN Number | 81-3263572 |
| Address: | 3450 E Fletcher Ave, Suite 100, TAMPA, FL, 33613, US |
| Mail Address: | 3450 E Fletcher Ave, Suite 100, TAMPA, FL, 33613, US |
| ZIP code: | 33613 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710434626 | 2016-09-08 | 2019-03-11 | 3450 E FLETCHER AVE STE 100, TAMPA, FL, 336134603, US | 3450 E FLETCHER AVE STE 100, TAMPA, FL, 336134603, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 813-812-4133 |
| Fax | 8135013633 |
Authorized person
| Name | DR. RONALD SALAZAR MANALO |
| Role | PRESIDENT |
| Phone | 6158385198 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 019212900 |
| State | FL |
| Name | Role |
|---|---|
| FRESH LEGAL PERSPECTIVE, PL | Agent |
| Name | Role | Address |
|---|---|---|
| MANALO RONALD S | Authorized Member | 3450 E Fletcher Ave, TAMPA, FL, 33613 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000071152 | FLORIDA FAMILY PRACTICE | ACTIVE | 2016-07-19 | 2026-12-31 | No data | 3450 EAST FLETCHER AVENUE, SUITE 100, TAMPA, FL, 33613 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-04-28 | No data | No data |
| LC AMENDMENT | 2022-07-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-08 | 3450 E Fletcher Ave, Suite 100, TAMPA, FL 33613 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-02-08 | Fresh Legal Perspective, PL | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-23 | 3450 E Fletcher Ave, Suite 100, TAMPA, FL 33613 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-01-30 | 6930 W Linebaugh Avenue, Tampa, FL 33625 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-04-28 |
| LC Amendment | 2022-07-28 |
| ANNUAL REPORT | 2022-02-08 |
| ANNUAL REPORT | 2021-01-31 |
| ANNUAL REPORT | 2020-03-23 |
| ANNUAL REPORT | 2019-01-27 |
| ANNUAL REPORT | 2018-01-30 |
| ANNUAL REPORT | 2017-01-06 |
| Florida Limited Liability | 2016-07-11 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
