| Entity Name: | SOUTH CARE MEDICAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Sep 2018 (6 years ago) |
| Document Number: | L18000222453 |
| FEI/EIN Number | 83-1963741 |
| Address: | 4522 W. VILLAGE DRIVE, # 202, TAMPA, FL, 33624 |
| Mail Address: | 4522 W. VILLAGE DRIVE, # 202, TAMPA, FL, 33624 |
| ZIP code: | 33624 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982261681 | 2019-05-29 | 2019-05-29 | 4522 W VILLAGE DR STE 202, TAMPA, FL, 336243429, US | 6822 W WATERS AVE, TAMPA, FL, 33634, US | |||||||||||||
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| Phone | +1 813-969-1700 |
Authorized person
| Name | ALEJANDRO GONZALEZ |
| Role | OWNER |
| Phone | 8137707169 |
Taxonomy
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GONZALEZ ALEJANDRO | Agent | 4522 W. VILLAGE DRIVE, TAMPA, FL, 33624 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ ALEJANDRO | Manager | 4522 W. VILLAGE DRIVE, TAMPA, FL, 33624 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2019-03-31 | GONZALEZ, ALEJANDRO | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-01-23 |
| AMENDED ANNUAL REPORT | 2019-03-31 |
| ANNUAL REPORT | 2019-02-04 |
| Florida Limited Liability | 2018-09-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
