| Entity Name: | INTENSIVIST MEDICINE SERVICES OF FL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Active |
| Date Filed: | 15 Feb 2023 (2 years ago) |
| Document Number: | M23000002042 |
| FEI/EIN Number | N/A |
| Address: | 2901 W SWANN AVE, TAMPA, FL 33609 |
| Mail Address: | ONE PARK PLAZA, BUILDING 1, NASHVILLE, TN 37203 |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235836388 | 2023-02-09 | 2023-06-14 | 2000 HEALTH PARK DR, BRENTWOOD, TN, 370274692, US | 2901 W SWANN AVE, TAMPA, FL, 336094056, US | |||||||||||||||
|
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| Phone | +1 615-373-7406 |
| Phone | +1 813-873-6400 |
Authorized person
| Name | MR. JOHN REBOK |
| Role | VICE PRESIDENT |
| Phone | 6153725004 |
Taxonomy
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| HCA-EMCARE HOLDINGS, LLC | Member | 1A BURTON HILLS BLVD, NASHVILLE, TN 37215 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-05-31 | 2901 W SWANN AVE, TAMPA, FL 33609 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-31 |
| Foreign Limited | 2023-02-15 |
Date of last update: 10 Jan 2025
Sources: Florida Department of State
