| Entity Name: | D TODD GRIFFITH MD LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 15 Apr 2020 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 05 Aug 2020 (5 years ago) |
| Document Number: | L20000104120 |
| FEI/EIN Number | 850765548 |
| Address: | 2701 WEST BUSCH BOULEVARD, TAMPA, FL, 33618, US |
| Mail Address: | 2701 WEST BUSCH BOULEVARD, SUITE 144, TAMPA, FL, 33618, US |
| ZIP code: | 33618 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134740400 | 2020-04-28 | 2020-07-27 | 5004 E FOWLER AVE # C113, TAMPA, FL, 336172181, US | 2701 W BUSCH BLVD STE 144, TAMPA, FL, 336184578, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 813-452-5000 |
Authorized person
| Name | DANIEL T GRIFFITH |
| Role | MEDICAL DIRECTOR |
| Phone | 8134525000 |
Taxonomy
| Taxonomy Code | 2083A0300X - Addiction Medicine (Preventive Medicine) Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BAY AREA SUBOXONE 401(K) PLAN | 2022 | 850765548 | 2023-09-27 | D TODD GRIFFITH MD LLC | 1 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2023-09-27 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-03-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8139300003 |
| Plan sponsor’s address | 2701 W BUSCH BLVD SUITE 144, TAMPA, FL, 33618 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-12 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| GRIFFITH DANIEL T | Agent | 2701 WEST BUSCH BOULEVARD, TAMPA, FL, 33618 |
| Name | Role | Address |
|---|---|---|
| GRIFFITH DANIEL T | Manager | 2701 WEST BUSCH BOULEVARD, TAMPA, FL, 33618 |
| Farr Kristi M | Manager | 2701 WEST BUSCH BOULEVARD, TAMPA, FL, 33618 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000044812 | BAY AREA SUBOXONE | ACTIVE | 2020-04-23 | 2025-12-31 | No data | 2701 W BUSCH BLVD SUITE 144, TAMPA, FL, 33618 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-14 | 2701 WEST BUSCH BOULEVARD, Suite 144, TAMPA, FL 33618 | No data |
| LC AMENDMENT | 2020-08-10 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2020-08-10 | 2701 WEST BUSCH BOULEVARD, Suite 144, TAMPA, FL 33618 | No data |
| LC AMENDMENT | 2020-08-05 | No data | No data |
| LC AMENDMENT | 2020-05-15 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J22000120628 | TERMINATED | 1000000918002 | HILLSBOROU | 2022-03-08 | 2032-03-09 | $ 1,077.82 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, TAMPA SERVICE CENTER, 5483 W WATERS AVE STE 1210, TAMPA FL336341236 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-18 |
| ANNUAL REPORT | 2023-04-06 |
| ANNUAL REPORT | 2022-02-16 |
| ANNUAL REPORT | 2021-04-14 |
| LC Amendment | 2020-08-10 |
| LC Amendment | 2020-08-05 |
| LC Amendment | 2020-05-15 |
| Florida Limited Liability | 2020-04-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
