| Entity Name: | BAY AREA IPA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Sep 2020 (4 years ago) |
| Document Number: | L20000297833 |
| FEI/EIN Number | 85-3271837 |
| Address: | 8911 SILVERTHORN ROAD, LARGO, FL, 33777, US |
| Mail Address: | 8911 SILVERTHORN ROAD, LARGO, FL, 33777, US |
| ZIP code: | 33777 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720686843 | 2020-10-12 | 2020-10-12 | 8911 SILVERTHORN RD, LARGO, FL, 337773170, US | 8911 SILVERTHORN RD, LARGO, FL, 337773170, US | |||||||||||||||||||
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| Phone | +1 727-270-0034 |
Authorized person
| Name | SHITAL MEHTA |
| Role | OWNER |
| Phone | 8139648526 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 271714000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TIRUPATHI PANEENDRA | Agent | 8911 SILVERTHORN ROAD, LARGO, FL, 33777 |
| Name | Role | Address |
|---|---|---|
| TIRUPATHI SREELATHA | Authorized Member | 8911 SILVERTHORN ROAD, LARGO, FL, 33777 |
| MEHTA SHITAL | Authorized Member | 6328 GUNN HIGHWAY, SUITE B, TAMPA, FL, 33625 |
| Name | Role | Address |
|---|---|---|
| TIRUPATHI PANEENDRA | Manager | 8911 SILVERTHORN ROAD, LARGO, FL, 33777 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-10 |
| ANNUAL REPORT | 2023-04-06 |
| ANNUAL REPORT | 2022-04-07 |
| ANNUAL REPORT | 2021-04-09 |
| Florida Limited Liability | 2020-09-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
