| Entity Name: | SA-PG - TAMPA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 18 Jun 2002 (23 years ago) |
| Date of dissolution: | 22 Mar 2017 (8 years ago) |
| Last Event: | LC WITHDRAWAL |
| Event Date Filed: | 22 Mar 2017 (8 years ago) |
| Document Number: | M02000001577 |
| FEI/EIN Number |
010716243
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4 WEST RED OAK LN, 201, WHITE PLAINS, NY, 10604 |
| Mail Address: | 4 WEST RED OAK LN, 201, WHITE PLAINS, NY, 10604 |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629074851 | 2005-06-22 | 2008-07-22 | 3612 E 138TH AVE, TAMPA, FL, 336134703, US | 3612 E 138TH AVE, TAMPA, FL, 336134703, US | |||||||||||||||||||||||||
|
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| Phone | +1 813-972-8775 |
| Fax | 8139780680 |
Authorized person
| Name | MR. ALEX PALEY |
| Role | COO |
| Phone | 9143904363 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF1420095 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025752400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SA-PG OPERATOR HOLDINGS, LLC | Managing Member | 4 WEST RED OAK LN, 201, WHITE PLAINS, NY, 10604 |
| CORPORATION SERVICE COMPANY | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000045112 | PALM GARDEN OF TAMPA | EXPIRED | 2013-05-10 | 2018-12-31 | - | 3612 EAST 138TH AVENUE, TAMPA, FL, 33613 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC WITHDRAWAL | 2017-03-22 | - | - |
| REGISTERED AGENT NAME CHANGED | 2013-07-22 | CORPORATION SERVICE COMPANY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2013-07-22 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-21 | 4 WEST RED OAK LN, 201, WHITE PLAINS, NY 10604 | - |
| CHANGE OF MAILING ADDRESS | 2009-04-21 | 4 WEST RED OAK LN, 201, WHITE PLAINS, NY 10604 | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J09000031152 | TERMINATED | 006101653 | 17167 001738 | 2008-11-18 | 2029-01-22 | $ 20.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE/CENTRAL COLLECTIONS UNIT, 3490 MARTIN HURST RD, TALLAHASSEE FL323121702 |
| J09000265529 | TERMINATED | 006101653 | 17167 001738 | 2008-11-18 | 2029-01-28 | $ 20.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE/CENTRAL COLLECTIONS UNIT, 3490 MARTIN HURST RD, TALLAHASSEE FL323121702 |
| Name | Date |
|---|---|
| LC Withdrawal | 2017-03-22 |
| ANNUAL REPORT | 2016-04-21 |
| ANNUAL REPORT | 2015-04-21 |
| ANNUAL REPORT | 2014-02-19 |
| Reg. Agent Change | 2013-07-22 |
| ANNUAL REPORT | 2013-04-26 |
| ANNUAL REPORT | 2012-02-07 |
| ANNUAL REPORT | 2011-01-27 |
| ANNUAL REPORT | 2010-02-18 |
| Reg. Agent Change | 2009-12-18 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
