| Entity Name: | TAMPA PSYCHOLOGY GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Apr 2018 (7 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 24 Oct 2019 (5 years ago) |
| Document Number: | L18000097296 |
| FEI/EIN Number | 825260986 |
| Mail Address: | 1463 Oakfield Dr, Brandon, FL, 33511, US |
| Address: | 1463 OAKFIELD DR, BRANDON, FL, 33511, US |
| ZIP code: | 33511 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346738705 | 2018-05-01 | 2018-06-25 | 11111 SILVER DANCER DR, RIVERVIEW, FL, 335792354, US | 1463 OAKFIELD DR STE 109, BRANDON, FL, 33511, US | |||||||||||||||||||||||||||
|
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| Phone | +1 813-210-2355 |
| Phone | +1 813-992-1880 |
| Fax | 8132354181 |
Authorized person
| Name | ROCHELLE TAORMINA |
| Role | LICENSED PSYCHOLOGIST |
| Phone | 8132102355 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| Is Primary | Yes |
| Taxonomy Code | 103TC2200X - Clinical Child & Adolescent Psychologist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 016590900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TAORMINA ROCHELLE | Agent | 1463 OAKFIELD DR, BRANDON, FL, 33511 |
| Name | Role | Address |
|---|---|---|
| TAORMINA ROCHELLE | Authorized Member | 1463 OAKFIELD DR, BRANDON, FL, 33511 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2019-10-24 | 1463 OAKFIELD DR, STE 109, BRANDON, FL 33511 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-10-24 | TAORMINA, ROCHELLE | No data |
| REINSTATEMENT | 2019-10-24 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-06-28 | 1463 OAKFIELD DR, STE 109, BRANDON, FL 33511 | No data |
| LC AMENDMENT | 2018-06-26 | No data | No data |
| LC AMENDMENT AND NAME CHANGE | 2018-05-03 | TAMPA PSYCHOLOGY GROUP, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-05-03 | 1463 OAKFIELD DR, STE 109, BRANDON, FL 33511 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-02-04 |
| ANNUAL REPORT | 2021-01-08 |
| ANNUAL REPORT | 2020-02-15 |
| REINSTATEMENT | 2019-10-24 |
| LC Amendment | 2018-06-26 |
| LC Amendment and Name Change | 2018-05-03 |
| Florida Limited Liability | 2018-04-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
