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  5. TAMPA FAMILY HEALTH CENTERS, INC.

TAMPA FAMILY HEALTH CENTERS, INC.

Company Details

Entity Name: TAMPA FAMILY HEALTH CENTERS, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 08 Feb 1984 (41 years ago)
Document Number: N01318
FEI/EIN Number 592420282
Mail Address: PO BOX 82969, TAMPA, FL, 33682, US
Address: 302 W. Fletcher Avenue, TAMPA, FL, 33612, US
ZIP code: 33612
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1154044204 2022-09-23 2023-07-17 PO BOX 82969, TAMPA, FL, 336822969, US 302 W FLETCHER AVE, TAMPA, FL, 336123415, US

Contacts
Phone +1 813-955-6447

Authorized person
Name MRS. SHERRY HOBACK
Role CEO/PRESIDENT
Phone 8138660930

Taxonomy
Taxonomy Code 261QC1500X - Community Health Clinic/Center
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TAX DEFERRED ANNUITY PLAN OF TAMPA FAMILY HEALTH CENTERS, INC. 2012 592420282 2013-07-31 TAMPA FAMILY HEALTH CENTERS, INC. 4
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-07-01
Business code 624100
Plan sponsor’s address PO BOX 82969, TAMPA, FL, 33682

Signature of
Role Plan administrator
Date 2013-07-31
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF TAMPA FAMILY HEALTH CENTERS, INC. 2012 592420282 2013-07-31 TAMPA FAMILY HEALTH CENTERS, INC. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-08-01
Business code 624100
Plan sponsor’s address PO BOX 82969, TAMPA, FL, 33682

Signature of
Role Plan administrator
Date 2013-07-31
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF TAMPA FAMILY HEALTH CENTERS, INC. 2011 592420282 2012-07-16 TAMPA FAMILY HEALTH CENTERS, INC. 4
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-07-01
Business code 624100
Plan sponsor’s address PO BOX 82969, TAMPA, FL, 33682

Plan administrator’s name and address
Administrator’s EIN 592420282
Plan administrator’s name TAMPA FAMILY HEALTH CENTERS, INC.
Plan administrator’s address PO BOX 82969, TAMPA, FL, 33682

Signature of
Role Plan administrator
Date 2012-07-16
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF TAMPA FAMILY HEALTH CENTERS, INC. 2011 592420282 2012-07-16 TAMPA FAMILY HEALTH CENTERS, INC. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-08-01
Business code 624100
Plan sponsor’s address PO BOX 82969, TAMPA, FL, 33682

Plan administrator’s name and address
Administrator’s EIN 592420282
Plan administrator’s name TAMPA FAMILY HEALTH CENTERS, INC.
Plan administrator’s address PO BOX 82969, TAMPA, FL, 33682

Signature of
Role Plan administrator
Date 2012-07-16
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF TAMPA FAMILY HEALTH CENTERS 2010 592420282 2011-07-13 TAMPA FAMILY HEALTH CENTERS 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-08-01
Business code 624100
Sponsor’s telephone number 8138660930
Plan sponsor’s address PO BOX 82969, TAMPA, FL, 33682

Plan administrator’s name and address
Administrator’s EIN 592420282
Plan administrator’s name TAMPA FAMILY HEALTH CENTERS
Plan administrator’s address PO BOX 82969, TAMPA, FL, 33682
Administrator’s telephone number 8138660930

Signature of
Role Plan administrator
Date 2011-07-13
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF TAMPA FAMILY HEALTH CENTERS, INC. 2010 592420282 2011-07-13 TAMPA FAMILY HEALTH CENTERS, INC. 3
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-07-01
Business code 621410
Sponsor’s telephone number 8138660930
Plan sponsor’s address 1502 E FOWLER AVE, TAMPA, FL, 33612

Plan administrator’s name and address
Administrator’s EIN 592420282
Plan administrator’s name TAMPA FAMILY HEALTH CENTERS, INC.
Plan administrator’s address 1502 E FOWLER AVE, TAMPA, FL, 33612
Administrator’s telephone number 8138660930

Signature of
Role Plan administrator
Date 2011-07-13
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-13
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature
403B THRIFT PLAN OF TAMPA FAMILY HEALTH CENTERS, INC. 2009 592420282 2010-09-03 TAMPA FAMILY HEALTH CENTERS, INC. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-08-01
Business code 621410
Sponsor’s telephone number 8138660930
Plan sponsor’s address PO BOX 82969, TAMPA, FL, 33612

Plan administrator’s name and address
Administrator’s EIN 592420282
Plan administrator’s name TAMPA FAMILY HEALTH CENTERS, INC.
Plan administrator’s address PO BOX 82969, TAMPA, FL, 33612
Administrator’s telephone number 8138660930

Signature of
Role Plan administrator
Date 2010-09-03
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF TAMPA FAMILY HEALTH CENTERS, INC. 2009 592420282 2010-07-19 TAMPA FAMILY HEALTH CENTERS, INC. 2
Three-digit plan number (PN) 003
Effective date of plan 2002-07-01
Business code 621410
Sponsor’s telephone number 8138660930
Plan sponsor’s address 1502 E FOWLER AVE, TAMPA, FL, 33612

Plan administrator’s name and address
Administrator’s EIN 592420282
Plan administrator’s name TAMPA FAMILY HEALTH CENTERS, INC.
Plan administrator’s address 1502 E FOWLER AVE, TAMPA, FL, 33612
Administrator’s telephone number 8138660930

Signature of
Role Plan administrator
Date 2010-07-13
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-13
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF TAMPA FAMILY HEALTH CENTERS, INC. 2009 592420282 2010-07-27 TAMPA FAMILY HEALTH CENTERS, INC. 2
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-07-01
Business code 621410
Sponsor’s telephone number 8138660930
Plan sponsor’s address 1502 E FOWLER AVE, TAMPA, FL, 33612

Plan administrator’s name and address
Administrator’s EIN 592420282
Plan administrator’s name TAMPA FAMILY HEALTH CENTERS, INC.
Plan administrator’s address 1502 E FOWLER AVE, TAMPA, FL, 33612
Administrator’s telephone number 8138660930

Signature of
Role Plan administrator
Date 2010-07-27
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-27
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature
403B THRIFT PLAN OF TAMPA FAMILY HEALTH CENTERS, INC. 2009 592420282 2010-07-27 TAMPA FAMILY HEALTH CENTERS, INC. 7
Three-digit plan number (PN) 002
Effective date of plan 2003-08-01
Business code 621410
Sponsor’s telephone number 8138660930
Plan sponsor’s address PO BOX 82969, TAMPA, FL, 33612

Plan administrator’s name and address
Administrator’s EIN 592420282
Plan administrator’s name TAMPA FAMILY HEALTH CENTERS, INC.
Plan administrator’s address PO BOX 82969, TAMPA, FL, 33612
Administrator’s telephone number 8138660930

Signature of
Role Plan administrator
Date 2010-07-27
Name of individual signing P. DAVID BONHAM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Van Pelt Thomas COO Agent 302 W. Fletcher Avenue, TAMPA, FL, 33612

Director

Name Role Address
DOSTER BRIAN Director 302 W. Fletcher Avenue, TAMPA, FL, 33612

Chief Executive Officer

Name Role Address
HOBACK SHERRY Chief Executive Officer 302 W. Fletcher Avenue, TAMPA, FL, 33612

Chairman

Name Role Address
WHITE RODNEY Chairman 302 W. Fletcher Avenue, TAMPA, FL, 33612

Vice Chairman

Name Role Address
STEWART LUCILA Vice Chairman 302 W. Fletcher Avenue, TAMPA, FL, 33612

Secretary

Name Role Address
Romeus Sophia Secretary 302 W. Fletcher Avenue, TAMPA, FL, 33612

Treasurer

Name Role Address
JAMES ALFONSA Treasurer 302 W. Fletcher Avenue, TAMPA, FL, 33612

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G22000102599 SILVER BLOSSOM SENIOR HEALTH OF TAMPA FAMILY HEALTH CENTERS ACTIVE 2022-08-30 2027-12-31 No data 302 W. FLETCHER AVE, TAMPA, FL, 33612

Events

Event Type Filed Date Value Description
NAME CHANGE AMENDMENT 2007-09-11 TAMPA FAMILY HEALTH CENTERS, INC. No data

Related by officers

DOSTER BRIAN

COMMONWEALTH CAPITAL CORP. (OF PA)

HOBACK SHERRY

HOBACK, LLC TAMPA FAMILY SPECIALTY SERVICES, LLC

WHITE RODNEY

TOP IT OFF FASHION ACCESSORIES, INC. EAST COAST SHUTTERS, INC. ELITE MEDICAL TRANSPORTATION SERVICES CO WHITE SAND CONSULTANTS LLC INTERNATIONAL TELECOM CONNECTIONS, INC. SERIOUS TECHNOLOGIES, INC. CROSSFIRE, INC.

STEWART LUCILA

SALUD Y VIDA INFUSION CENTER LLC

Romeus Sophia

EDUCATION INSTITUTE OF TAMPA FAMILY INC.

Van Pelt Thomas COO

EDUCATION INSTITUTE OF TAMPA FAMILY INC.

Related by address

PO BOX 82969, TAMPA, FL, 33682, US

EDUCATION INSTITUTE OF TAMPA FAMILY INC.

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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