| Entity Name: | PROMEDTC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 May 2020 (5 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 01 Oct 2021 (3 years ago) |
| Document Number: | L20000127125 |
| FEI/EIN Number | 85-0930295 |
| Address: | 777 N ASHLEY DR, UNIT 1815, TAMPA, FL 33602 |
| Mail Address: | 777 N ASHLEY DR, UNIT 1815, TAMPA, FL 33602 |
| ZIP code: | 33602 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104441617 | 2020-06-10 | 2020-06-10 | 777 N ASHLEY DR UNIT 1815, TAMPA, FL, 336024373, US | 3109 LITHIA PINECREST RD, VALRICO, FL, 335965632, US | |||||||||||||||||||
|
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| Phone | +1 718-666-8759 |
Authorized person
| Name | TYMUR CHEPI-IPA |
| Role | MEDICAL DIRECTOR |
| Phone | 7186668759 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1548623432 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CHEPI-IPA, TYMUR, NP-C | Agent | 777 N ASHLEY DR, UNIT 1815, TAMPA, FL 33602 |
| Name | Role | Address |
|---|---|---|
| Chepiipa, Tymur | NP | 777 N ashley dr, unit 1815 tampa, FL 33602 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-06 | 777 N ASHLEY DR, UNIT 1815, TAMPA, FL 33602 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-06 | 777 N ASHLEY DR, UNIT 1815, TAMPA, FL 33602 | No data |
| REINSTATEMENT | 2021-10-01 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-10-01 | CHEPI-IPA, TYMUR, NP-C | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-04-10 |
| REINSTATEMENT | 2021-10-01 |
| Florida Limited Liability | 2020-05-11 |
Date of last update: 15 Feb 2025
Sources: Florida Department of State
