| Entity Name: | COMPLETE INTEGRATIVE MEDICAL CLINIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Jun 2020 (5 years ago) |
| Document Number: | L20000151407 |
| FEI/EIN Number | 85-0637099 |
| Address: | 2835 W DELEON ST, TAMPA, FL, 33609, US |
| Mail Address: | 2835 W DELEON ST, TAMPA, FL, 33609, US |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326665779 | 2020-07-01 | 2020-07-01 | PO BOX 75472, TAMPA, FL, 336750472, US | 2835 W DE LEON ST STE 102, TAMPA, FL, 336094130, US | |||||||||||||
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| Phone | +1 813-374-5584 |
Authorized person
| Name | AMANDA CAMP |
| Role | OWNER |
| Phone | 7277099770 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CAMP AMANDA | Agent | 2835 W DELEON ST, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| CAMP AMANDA | Authorized Member | 2835 DELEON ST, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| Wainwright Dana | Officer | 2835 W DELEON ST, TAMPA, FL, 33609 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-08 | 2835 W DELEON ST, 201, TAMPA, FL 33609 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-08 | 2835 W DELEON ST, 201, TAMPA, FL 33609 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-08 | 2835 W DELEON ST, 201, TAMPA, FL 33609 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-05-02 |
| ANNUAL REPORT | 2022-04-11 |
| ANNUAL REPORT | 2021-04-27 |
| Florida Limited Liability | 2020-06-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
