| Entity Name: | TAMPA BAY MAXILLOFACIAL SURGERY, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Sep 2017 (7 years ago) |
| Document Number: | L17000199833 |
| FEI/EIN Number | 82-2921313 |
| Address: | 2140 16TH STREET NORTH, ST. PETERSBURG, FL, 33704, US |
| Mail Address: | 2140 16TH STREET NORTH, ST. PETERSBURG, FL, 33704, US |
| ZIP code: | 33704 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164932356 | 2017-10-03 | 2019-06-21 | 4021 LAS PALMAS WAY, SARASOTA, FL, 342384531, US | 2140 16TH ST N, ST PETERSBURG, FL, 337043924, US | |||||||||||||||||||||||
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| Phone | +1 727-424-5540 |
| Phone | +1 727-894-1442 |
Authorized person
| Name | DR. ROBERT J YU |
| Role | MANAGING MEMBER |
| Phone | 7278941442 |
Taxonomy
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| Is Primary | Yes |
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QS0112X - Oral and Maxillofacial Surgery Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Yu Robert JDr. | Agent | 2140 16th Street North, St Petersburg, FL, 33704 |
| Name | Role | Address |
|---|---|---|
| YU ROBERT JD.M.D. | Manager | 2140 16TH STREET NORTH, ST. PETERSBURG, FL, 33704 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000049861 | ROBERT CHUONG, DMD MD | EXPIRED | 2018-04-19 | 2023-12-31 | No data | 2140 16TH ST. N., ST PETERSBURG, FL, 33704 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2019-01-26 | Yu, Robert J, Dr. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-01-26 | 2140 16th Street North, St Petersburg, FL 33704 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-08 |
| ANNUAL REPORT | 2024-01-22 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-01-22 |
| ANNUAL REPORT | 2021-01-09 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-01-26 |
| ANNUAL REPORT | 2018-01-16 |
| Florida Limited Liability | 2017-09-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
