| Entity Name: | INJURY TREATMENT CENTER CLINIC OF TAMPA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 08 Jun 2023 (2 years ago) |
| Document Number: | L23000279499 |
| FEI/EIN Number | 93-1780958 |
| Address: | 5471 W WATERS AVE, SUITE 300, TAMPA, FL 33634 |
| Mail Address: | 5811 MEMORIAL HIGHWAY, SUITE 103, TAMPA, FL 33615 |
| ZIP code: | 33634 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821867516 | 2023-12-22 | 2023-12-22 | 5811 MEMORIAL HWY STE 103, TAMPA, FL, 336155000, US | 5811 MEMORIAL HWY STE 103, TAMPA, FL, 336155000, US | |||||||||||||
|
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| Phone | +1 813-476-8212 |
Authorized person
| Name | DR. MARK SELDES |
| Role | OWNER/PHYSICIAN |
| Phone | 8134768212 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SELDES, MARK A | Agent | 5811 MEMORIAL HIGHWAY, SUITE 103, TAMPA, FL 33615 |
| Name | Role | Address |
|---|---|---|
| SELDES, MARK A | Manager | 5811 MEMORIAL HIGHWAY, SUITE 103, TAMPA, FL 33615 UN |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-29 | 5471 W WATERS AVE, SUITE 300, TAMPA, FL 33634 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-10 |
| Florida Limited Liability | 2023-06-08 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
