| Entity Name: | TAMPA PALMS PSYCHOLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 29 Sep 2020 (4 years ago) |
| Document Number: | L20000307756 |
| FEI/EIN Number | 85-3415245 |
| Address: | 16203 HAMPTON TRACE COURT, TAMPA, FL 33647 |
| Mail Address: | 5331 Primrose Lake Circle, SUITE 245, TAMPA, FL 33647 |
| ZIP code: | 33647 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679242648 | 2021-09-12 | 2021-09-12 | 17401 COMMERCE PARK BLVD STE 103-0319, TAMPA, FL, 336473501, US | 16203 HAMPTON TRACE CT, TAMPA, FL, 336472745, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 727-239-5684 |
Authorized person
| Name | DR. BRIAN ANDREW WILSON |
| Role | OWNER |
| Phone | 7272395684 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WILSON, BRIAN A, PHD | Agent | 16203 HAMPTON TRACE COURT, TAMPA, FL 33647 |
| Name | Role | Address |
|---|---|---|
| WILSON, BRIAN A, PHD | Manager | 16203 HAMPTON TRACE COURT, TAMPA, FL 33647 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2025-01-24 | 16203 HAMPTON TRACE COURT, TAMPA, FL 33647 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-24 |
| ANNUAL REPORT | 2024-01-26 |
| ANNUAL REPORT | 2023-02-02 |
| ANNUAL REPORT | 2022-02-22 |
| ANNUAL REPORT | 2021-02-07 |
| Florida Limited Liability | 2020-09-29 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
