| Entity Name: | CARROLLWOOD MEDICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 21 Jul 2016 (9 years ago) |
| Document Number: | L16000137503 |
| FEI/EIN Number | 81-3427963 |
| Mail Address: | 5901 WEBB ROAD, TAMPA, FL 33615 |
| Address: | 10213 Lake Carroll Way, Ste B, TAMPA, FL 33618 |
| ZIP code: | 33618 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982150348 | 2016-08-26 | 2016-08-26 | 5901 WEBB RD, TAMPA, FL, 336153219, US | 10213 LAKE CARROLL WAY, STE D, TAMPA, FL, 336184402, US | |||||||||||||||
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| Phone | +1 813-888-8215 |
| Fax | 8138855398 |
Authorized person
| Name | MR. ANTONIO CALVO JR. |
| Role | MANAGER |
| Phone | 8138888215 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Name | Role |
|---|---|
| BUBLEY & BUBLEY, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| REVELLO, PATRICIA | Manager | 3646 MARBURY COURT, LAND O'LAKES,, FL 33638 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-11-22 | 10213 Lake Carroll Way, Ste B, TAMPA, FL 33618 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-08-12 |
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-02-15 |
| ANNUAL REPORT | 2021-02-15 |
| ANNUAL REPORT | 2020-02-13 |
| ANNUAL REPORT | 2019-01-31 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-02-20 |
| Florida Limited Liability | 2016-07-21 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
