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  5. TAMPA GENERAL PROVIDER NETWORK, INC.

TAMPA GENERAL PROVIDER NETWORK, INC.

Company Details

Entity Name: TAMPA GENERAL PROVIDER NETWORK, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Not For Profit Corporation
Status: Active
Date Filed: 14 Dec 2020 (4 years ago)
Document Number: N20000013762
FEI/EIN Number 86-1810505
Address: 4620 PGA Blvd, Suite 101, Palm Beach Gardens, FL 33418
Mail Address: Attn: HIM/Release of Information, P. O. Box 1289, Tampa, FL 33601
ZIP code: 33418
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1871320408 2024-09-17 2024-09-17 PO BOX 95000-7370, PHILADELPHIA, PA, 191950001, US 1411 N FLAGLER DR STE 5600, WEST PALM BEACH, FL, 334013412, US

Contacts
Phone +1 561-659-6543
Fax 5616593533

Authorized person
Name ABRAHAM B SCHWARZBERG
Role PRESIDENT
Phone 5612533980

Taxonomy
Taxonomy Code 207RG0100X - Gastroenterology Physician
Is Primary Yes

Agent

Name Role
CF REGISTERED AGENT, INC. Agent

President

Name Role Address
SCHWARZBERG, ABRAHAM, MD President ONE TAMPA GENERAL CIR, TAMPA, FL 33606-3571

Director

Name Role Address
SCHWARZBERG, ABRAHAM, MD Director ONE TAMPA GENERAL CIR, TAMPA, FL 33606-3571
BRANDT, STACEY Director ONE TAMPA GENERAL CIR, TAMPA, FL 33606-3571
RUNYON, MARK Director ONE TAMPA GENERAL CIR, TAMPA, FL 33606-3571
COURIS, JOHN Director ONE TAMPA GENERAL CIR, TAMPA, FL 33606-3571
SMITH, ADAM Director ONE TAMPA GENERAL CIR, TAMPA, FL 33606-3571

Chair

Name Role Address
COURIS, JOHN Chair ONE TAMPA GENERAL CIR, TAMPA, FL 33606-3571

Treasurer

Name Role Address
PUGH, JENNIFER Treasurer ONE TAMPA GENERAL CIR, TAMPA, FL 33606-3571

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000077490 TGH PULMONARY CARE & SLEEP INSTITUTE ACTIVE 2024-06-25 2029-12-31 No data 10131 FOREST HILL BLVD., SUITE 100B, WELLINGTON, FL, 33414
G24000077479 TAMPA GENERAL HOSPITAL PCSI PULMONARY CARE & SLEEP INSTITUTE ACTIVE 2024-06-25 2029-12-31 No data 10131 FOREST HILL BLVD., SUITE 100B, WELLINGTON, FL, 33414
G24000077481 TAMPA GENERAL HOSPITAL PCSI ACTIVE 2024-06-25 2029-12-31 No data 10131 FOREST HILL BLVD., SUITE 100B, WELLINGTON, FL, 33414
G24000077484 TGH PCSI ACTIVE 2024-06-25 2029-12-31 No data 10131 FOREST HILL BLVD., SUITE 100B, WELLINGTON, FL, 33414
G24000077488 TAMPA GENERAL HOSPITAL PULMONARY CARE & SLEEP INSTITUTE ACTIVE 2024-06-25 2029-12-31 No data 10131 FOREST HILL BLVD., SUITE 100B, WELLINGTON, FL, 33414
G24000077446 TGH UROLOGY GROUP OF FLORIDA ACTIVE 2024-06-25 2029-12-31 No data 4889 S. CONGRESS AVENUE, FIRST FLOOR, LAKE WORTH, FL, 33461
G24000077448 TGH UROLOGY GROUP OF FLORIDA ACTIVE 2024-06-25 2029-12-31 No data 3399 PGA BLVD., SUITE 220, PALM BEACH GARDENS, FL, 33410
G24000077449 TGH UROLOGY GROUP OF FLORIDA ACTIVE 2024-06-25 2029-12-31 No data 5350 W. ATLANTIC AVENUE, SUITE 102, DELRAY BEACH, FL, 33484
G24000077455 TGH PCSI PULMONARY CARE & SLEEP INSTITUTE ACTIVE 2024-06-25 2029-12-31 No data 5401 S. CONGRESS AVENUE, SUITE 204, ATLANTIS, FL, 33462
G24000077457 TAMPA GENERAL HOSPITAL PCSI PULMONARY CARE & SLEEP INSTITUTE ACTIVE 2024-06-25 2029-12-31 No data 5401 S. CONGRESS AVENUE, SUITE 204, ATLANTIS, FL, 33462

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2024-12-12 4620 PGA Blvd, Suite 101, Palm Beach Gardens, FL 33418 No data
CHANGE OF PRINCIPAL ADDRESS 2024-11-25 4620 PGA Blvd, Suite 101, Palm Beach Gardens, FL 33418 No data

Documents

Name Date
ANNUAL REPORT 2024-01-24
ANNUAL REPORT 2023-05-01
ANNUAL REPORT 2022-04-30
ANNUAL REPORT 2021-04-27
Domestic Non-Profit 2020-12-14

Related by officers

BRANDT, STACEY

TGH AMBULATORY SERVICES COMPANY ACADEMIC MEDICAL GROUP, INC.

RUNYON, MARK

TAMPA GENERAL MEDICAL GROUP, INC. ACADEMIC MEDICAL GROUP, INC.

COURIS, JOHN

TGH AMBULATORY SERVICES COMPANY FOREVER FROSTY FOUNDATION, INC. WILL PROFIT, LLC SUGARMAG LLC ACADEMIC MEDICAL GROUP, INC. FAMILY RESOURCES & SOLUTIONS, INC.

SMITH, ADAM

TAMPA GENERAL MEDICAL GROUP, INC. NEW GENESIS COMMUNITY, INC. 560 CENTRAL AVE., LLC FRIENDS OF LITTLE RIVER, INC. 5H VIZCAYA, LLC A-TEAM TECHS, LLC 670 GOODLETTE, LLC 191 7TH AVE. N., LLC 5TH ST. N., LLC 950 6TH AVE. S., LLC

PUGH, JENNIFER

NEW START BOYS CLUB INC.

Related by address

No related companies by address

Date of last update: 15 Jan 2025

Sources: Florida Department of State

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