| Entity Name: | OMNI INTEGRATIVE MEDICINE OF TAMPA PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 26 May 2022 (3 years ago) |
| Date of dissolution: | 27 Sep 2024 (5 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (5 months ago) |
| Document Number: | L22000230636 |
| FEI/EIN Number | 88-2501239 |
| Address: | 10933 COUNTRYWAY BLVD, TAMPA, FL 33626 |
| Mail Address: | 10933 COUNTRYWAY BLVD, TAMPA, FL 33626 |
| ZIP code: | 33626 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225743917 | 2023-01-18 | 2023-01-18 | 10933 COUNTRYWAY BLVD, TAMPA, FL, 336262630, US | 10933 COUNTRYWAY BLVD, TAMPA, FL, 336262630, US | |||||||||||||
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| Phone | +1 813-568-1131 |
Authorized person
| Name | DR. ROBERT RAOUF ABRAHAM |
| Role | OWNER |
| Phone | 3212173986 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OMNI INTEGRATIVE MEDICINE OF TAMPA PLLC 401(K) PLAN | 2023 | 882501239 | 2024-05-20 | OMNI INTEGRATIVE MEDICINE OF TAMPA PLLC | 0 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-20 |
| Name of individual signing | QIAN LIU |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| X LLC | Agent |
| Name | Role | Address |
|---|---|---|
| Abraham, Robert | Chief Executive Officer | 10933 COUNTRYWAY BLVD, TAMPA, FL 33626 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000082751 | NEXTGEN MEDICAL | ACTIVE | 2023-07-13 | 2028-12-31 | No data | 333 S GARLAND AVE, FLOOR 13, ORLANDO, FL, 32801 |
| G23000001208 | NEXTGEN MEDICAL | ACTIVE | 2023-01-04 | 2028-12-31 | No data | 10933 COUNTRYWAY BLVD, TAMPA, FL, 33626 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REINSTATEMENT | 2023-11-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| Name | Date |
|---|---|
| Reg. Agent Resignation | 2024-02-01 |
| REINSTATEMENT | 2023-11-08 |
| Florida Limited Liability | 2022-05-26 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
