| Entity Name: | TAMPA NEUROLOGY GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 18 Mar 2024 (10 months ago) |
| Document Number: | L24000125787 |
| Address: | 401 E. JACKSON ST., STE. 2340, TAMPA, FL 33602 |
| Mail Address: | 401 E. JACKSON ST., STE. 2340, TAMPA, FL 33602 |
| ZIP code: | 33602 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023878881 | 2024-03-20 | 2024-03-20 | 401 E JACKSON ST STE 2340, TAMPA, FL, 336025226, US | 401 E JACKSON ST STE 2340, TAMPA, FL, 336025226, US | |||||||||||||||||||
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| Phone | +1 813-934-2248 |
| Fax | 8139342247 |
Authorized person
| Name | TAMMY CARPENTER |
| Role | OFFICE MANAGER |
| Phone | 8139342248 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| Is Primary | Yes |
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | No |
| Name | Role |
|---|---|
| CORPORATE CREATIONS NETWORK INC. | Agent |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN, BRAD | Manager | 401 E. JACKSON ST., STE. 2340, TAMPA, FL 33602 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-03-18 |
Date of last update: 07 Jan 2025
Sources: Florida Department of State
