| Entity Name: | MAGNOLIA GYNECOLOGY, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 04 Aug 2020 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 03 Dec 2020 (4 years ago) |
| Document Number: | L20000234811 |
| FEI/EIN Number | 85-2455271 |
| Address: | 3216 W Azeele St. Ste. 2, TAMPA, FL 33609 |
| Mail Address: | 3216 W Azeele St. Ste. 2, TAMPA, FL 33609 |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063024149 | 2020-08-19 | 2024-09-05 | 3216 W AZEELE ST STE 2, TAMPA, FL, 336093151, US | 3216 W AZEELE ST STE 2, TAMPA, FL, 336093018, US | |||||||||||||||
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| Phone | +1 813-773-6627 |
| Fax | 8134436001 |
Authorized person
| Name | ALEXANDRIA R. REYES |
| Role | PHYSICIAN OWNER |
| Phone | 8137736627 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GASSMAN, ALAN S, ESQ. | Agent | 1245 COURT STREET, CLEARWATER, FL 33756 |
| Name | Role | Address |
|---|---|---|
| REYES, ALEXANDRIA | Manager | 1000 W Kennedy Blvd, Suite 201 TAMPA, FL 33606 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-12-12 | 3216 W Azeele St. Ste. 2, TAMPA, FL 33609 | No data |
| CHANGE OF MAILING ADDRESS | 2023-12-12 | 3216 W Azeele St. Ste. 2, TAMPA, FL 33609 | No data |
| LC AMENDMENT | 2020-12-03 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-15 |
| AMENDED ANNUAL REPORT | 2023-02-10 |
| ANNUAL REPORT | 2023-01-13 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-01-14 |
| LC Amendment | 2020-12-03 |
| Florida Limited Liability | 2020-08-04 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
