| Entity Name: | BAYSIDE MEDICAL GROUP OF FLORIDA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Nov 2021 (3 years ago) |
| Document Number: | L21000488304 |
| FEI/EIN Number | 87-3530953 |
| Address: | 7918 W. HILLSBOROUGH AVE, TAMPA, FL, 33615 |
| Mail Address: | 7918 W. Hillsborough Ave, TAMPA, FL, 33615, US |
| ZIP code: | 33615 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558012211 | 2022-01-14 | 2022-11-03 | 7918 W HILLSBOROUGH AVENUE, TAMPA, FL, 336154608, US | 7918 W HILLSBOROUGH AVE, TAMPA, FL, 336154608, US | |||||||||||||||||||
|
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| Phone | +1 813-374-2444 |
| Fax | 8136447040 |
Authorized person
| Name | ROBERT LEON |
| Role | GENERAL MANAGER |
| Phone | 8133742444 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Leon Roberto | Agent | 7918 W. HILLSBOROUGH AVE, TAMPA, FL, 33615 |
| Name | Role | Address |
|---|---|---|
| Leon Roberto | Manager | 7918 W. Hillsborough Ave, Tampa, FL, 33615 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-01-12 | Leon, Roberto | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-18 | 7918 W. HILLSBOROUGH AVE, TAMPA, FL 33615 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-12 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-01-18 |
| Florida Limited Liability | 2021-11-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
