| Entity Name: | ELITECAREMDS TAMPA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Jun 2024 (8 months ago) |
| Document Number: | L24000253161 |
| Address: | 4504 W DALE AVE, TAMPA, FL, 33609, US |
| Mail Address: | 4504 W DALE AVE, TAMPA, FL, 33609, US |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225878432 | 2024-05-28 | 2024-10-19 | 4504 W DALE AVE, TAMPA, FL, 336093709, US | 4504 W DALE AVE, TAMPA, FL, 336093709, US | |||||||||||||||||
|
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| Phone | +1 732-713-4479 |
Authorized person
| Name | DR. DIPTI PATEL |
| Role | PHYSICIAN |
| Phone | 7327134479 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| PATEL DIPTI | Agent | 4504 W DALE AVE, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| PATEL DIPTI | Manager | 4504 W DALE AVE, TAMPA, FL, 33609 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-06-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
