| Entity Name: | TAMPA BAY PREMIER OBGYN, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 13 Mar 2019 (6 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L19000071081 |
| FEI/EIN Number | 83-3946052 |
| Address: | 2727 W. DR. MLK JR. BLVD., SUITE 630, TAMPA, FL 33607 |
| Mail Address: | 2727 W. DR. MLK JR. BLVD., SUITE 630, TAMPA, FL 33607 |
| ZIP code: | 33607 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811459563 | 2019-04-02 | 2019-04-02 | 2727 W DR MLK BLVD STE 630, TAMPA, FL, 336076399, US | 2727 W DR MLK BLVD STE 630, TAMPA, FL, 336076399, US | |||||||||||||||
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| Phone | +1 813-876-6000 |
| Fax | 8138727459 |
Authorized person
| Name | VICKIE GONZALEZ |
| Role | MANAGER |
| Phone | 8138766000 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RUGG, JOSEPH | Agent | 401 EAST JACKSON STREET, SUITE 3100, TAMPA, FL 33602 |
| Name | Role | Address |
|---|---|---|
| DAVIS, MARK R, M.D. | Manager | 2727 W. DR. MLK JR. BLVD., SUITE 630, TAMPA, FL 33607 |
| MARTINEZ, LUCIANO A, M.D. | Manager | 2727 W. DR. MLK JR. BLVD., SUITE 630, TAMPA, FL 33607 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-06-29 |
| Florida Limited Liability | 2019-03-13 |
Date of last update: 16 Feb 2025
Sources: Florida Department of State
