| Entity Name: | RAG MEDICAL CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 May 2019 (6 years ago) |
| Document Number: | L19000126161 |
| FEI/EIN Number | 834701712 |
| Address: | 6408 N ARMENIA AVE, TAMPA, FL, 33604, US |
| Mail Address: | 6408 N ARMENIA AVE, TAMPA, FL, 33604, US |
| ZIP code: | 33604 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528624053 | 2019-05-09 | 2022-10-10 | 6408 N ARMENIA AVE STE B-1, TAMPA, FL, 336045770, US | 6408 N ARMENIA AVE STE B-1, TAMPA, FL, 336045770, US | |||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 813-352-8305 |
Authorized person
| Name | RICARDO A GOMEZ FERNANDEZ |
| Role | ADMINISTRATOR |
| Phone | 8133528305 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207RA0401X - Addiction Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP3300X - Pain Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| GOMEZ FERNANDEZ RICARDO A | Agent | 6408 N ARMENIA AVE, TAMPA, FL, 33604 |
| Name | Role | Address |
|---|---|---|
| GOMEZ FERNANDEZ RICARDO A | Manager | 6408 N ARMENIA AVE SUITE B-1, TAMPA, FL, 33604 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000062453 | PHOENIX MEDICAL CLINIC | ACTIVE | 2019-05-29 | 2029-12-31 | No data | 6408 N ARMENIA AVE STE B1, TAMPA, FL, 33604 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-08-17 | 6408 N ARMENIA AVE, SUITE B-1, TAMPA, FL 33604 | No data |
| CHANGE OF MAILING ADDRESS | 2021-08-17 | 6408 N ARMENIA AVE, SUITE B-1, TAMPA, FL 33604 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-08-17 | 6408 N ARMENIA AVE, SUITE B-1, TAMPA, FL 33604 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-12 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-03-06 |
| ANNUAL REPORT | 2020-01-21 |
| Florida Limited Liability | 2019-05-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
