| Entity Name: | SPECIALIZED PSYCHIATRIC CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 03 Feb 2020 (5 years ago) |
| Document Number: | L20000039554 |
| FEI/EIN Number | 84-4719355 |
| Address: | 10347 Cross Creek Blvd, SUITE D, TAMPA, FL 33647 |
| Mail Address: | 9307 CYPRESS BEND DRIVE, TAMPA, FL 33647 |
| ZIP code: | 33647 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700411360 | 2020-03-04 | 2020-12-16 | 9307 CYPRESS BEND DR, TAMPA, FL, 336472553, US | 5331 PRIMROSE LAKE CIR STE 110, TAMPA, FL, 336473764, US | |||||||||||||||||||||||||
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| Phone | +1 813-919-5508 |
| Fax | 4107012444 |
Authorized person
| Name | DAVID J CAMPOPIANO |
| Role | OWNER & PROVIDER |
| Phone | 8139195508 |
Taxonomy
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE LICENSE |
| Number | ARNP9329419 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CAMPOPIANO, DAVID J, NP | Agent | 9307 CYPRESS BEND DRIVE, TAMPA, FL 33647 |
| Name | Role | Address |
|---|---|---|
| CAMPOPIANO, DAVID J, NP | Manager | 9307 CYPRESS BEND DRIVE, TAMPA, FL 33647 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-29 | 10347 Cross Creek Blvd, SUITE D, TAMPA, FL 33647 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-03-19 |
| ANNUAL REPORT | 2021-01-28 |
| Florida Limited Liability | 2020-02-03 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6034257408 | 2020-05-13 | 0455 | PPP | 27552 CASHFORD CIR SUITE 102, WESLEY CHAPEL, FL, 33544-6951 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 15 Feb 2025
Sources: Florida Department of State
