| Entity Name: | UPSHAW TMS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 May 2018 (7 years ago) |
| Document Number: | L18000128438 |
| FEI/EIN Number | 83-0604863 |
| Address: | 6511 Gunn Hwy, Tampa, FL, 33625, US |
| Mail Address: | 6511 Gunn Hwy, Tampa, FL, 33625, US |
| ZIP code: | 33625 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629560545 | 2018-06-06 | 2024-10-02 | 6511 GUNN HWY, TAMPA, FL, 336254021, US | 6511 GUNN HWY, TAMPA, FL, 336254021, US | |||||||||||||||||||||||||||
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| Phone | +1 813-731-5807 |
Authorized person
| Name | MS. TAMI J BROCHMAN |
| Role | DIR OF HR, COMPLIANCE & CORP ADMIN |
| Phone | 8136051122 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | ME96275 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAL LICENSE |
| Number | ME96275 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NEUROSPA 401(K) PLAN | 2023 | 830604863 | 2024-07-18 | UPSHAW TMS LLC | 40 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-18 |
| Name of individual signing | MONICA BERND |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Bernd Monica | Agent | 6511 Gunn Hwy, Tampa, FL, 336254021 |
| Name | Role | Address |
|---|---|---|
| Obregon Demian | Manager | 6511 Gunn Hwy, Tampa, FL, 33625 |
| Name | Role | Address |
|---|---|---|
| Bernd Monica | Auth | 6511 Gunn Hwy, Tampa, FL, 33625 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000041767 | NEUROSPA THERAPY CENTERS | ACTIVE | 2023-03-31 | 2028-12-31 | No data | 6511 GUNN HIGHWAY, TAMPA, FL, 33625 |
| G18000062509 | NEUROSPA | ACTIVE | 2018-05-25 | 2028-12-31 | No data | 6511 GUNN HIGHWAY, TAMPA, FL, 33625 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-09-06 | Bernd, Monica | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-15 | 6511 Gunn Hwy, Tampa, FL 33625-4021 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-24 | 6511 Gunn Hwy, Tampa, FL 33625 | No data |
| CHANGE OF MAILING ADDRESS | 2020-03-24 | 6511 Gunn Hwy, Tampa, FL 33625 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-08 |
| AMENDED ANNUAL REPORT | 2024-09-06 |
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-15 |
| ANNUAL REPORT | 2020-03-24 |
| ANNUAL REPORT | 2019-04-19 |
| Florida Limited Liability | 2018-05-22 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
