| Entity Name: | PRIME ENDOCRINOLOGY OF TAMPA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 11 Jan 2021 (4 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 27 Aug 2021 (3 years ago) |
| Document Number: | L21000024753 |
| FEI/EIN Number | 86-1761471 |
| Mail Address: | 8837 CITRUS PALM DRIVE, TAMPA, FL, 33626, US |
| Address: | 6579 GUNN HWY, TAMPA, FL, 33625, US |
| ZIP code: | 33625 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275108854 | 2021-05-25 | 2021-05-25 | 2410 NORTHSIDE DR, CLEARWATER, FL, 337612236, US | 8837 CITRUS PALM DR, TAMPA, FL, 336264735, US | |||||||||||||||||||||
|
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| Phone | +1 727-499-0356 |
| Fax | 7277813312 |
Authorized person
| Name | DR. ARCHANA SWAMI |
| Role | PHYSICIAN/OWNER |
| Phone | 7274990356 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE |
| Number | ME134258 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SWAMI ARCHANA | Agent | 8837 CITRUS PALM DRIVE, TAMPA, FL, 33626 |
| Name | Role | Address |
|---|---|---|
| SWAMI ARCHANA | Manager | 4290 W LINEBAUGH AVENUE, TAMPA, FL, 33624 |
| SWAMI VIJAY | Manager | 8837 CITRUS PALM DRIVE, TAMPA, FL, 33626 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-07 | 6579 GUNN HWY, TAMPA, FL 33625 | No data |
| LC AMENDMENT | 2021-08-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-08-27 | 4290 W. LINEBAUGH AVENUE, SUITE B, TAMPA, FL 33624 | No data |
| LC AMENDMENT | 2021-02-16 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-20 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-03-14 |
| LC Amendment | 2021-08-27 |
| LC Amendment | 2021-02-16 |
| Florida Limited Liability | 2021-01-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
