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  5. TAMPA LUNG SPECIALISTS, P.A.

TAMPA LUNG SPECIALISTS, P.A.

Company Details

Entity Name: TAMPA LUNG SPECIALISTS, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 16 Apr 2002 (23 years ago)
Document Number: P02000041179
FEI/EIN Number 680498643
Address: 4129 NORTH ARMENIA AVENUE, SUITE B, TAMPA, FL, 33607
Mail Address: 4129 NORTH ARMENIA AVENUE, SUITE B, TAMPA, FL, 33607
ZIP code: 33607
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1407971419 2007-03-20 2023-09-20 4129 N ARMENIA AVE, STE B, TAMPA, FL, 336076436, US 4129 N ARMENIA AVE, STE B, TAMPA, FL, 336076436, US

Contacts
Phone +1 813-879-3699
Fax 8138738469

Authorized person
Name PETER S MCINTIRE
Role ADMIN
Phone 8137777823

Taxonomy
Taxonomy Code 207RP1001X - Pulmonary Disease Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 266378300
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TAMPA LUNG SPECIALISTS, P. A. 401(K) PLAN 2022 680498643 2023-10-04 TAMPA LUNG SPECIALISTS, P. A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8138793699
Plan sponsor’s address 4129 N. ARMENIA AVENUE, TAMPA, FL, 33607
TAMPA LUNG SPECIALISTS, P. A. 401(K) PLAN 2022 680498643 2023-10-12 TAMPA LUNG SPECIALISTS, P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8138793699
Plan sponsor’s address 4129 N. ARMENIA AVENUE, TAMPA, FL, 33607
TAMPA LUNG SPECIALISTS, P. A. 401(K) PLAN 2022 680498643 2023-10-04 TAMPA LUNG SPECIALISTS, P. A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8138793699
Plan sponsor’s address 4129 N. ARMENIA AVENUE, TAMPA, FL, 33607
TAMPA LUNG SPECIALISTS, P. A. 401(K) PLAN 2021 680498643 2023-10-04 TAMPA LUNG SPECIALISTS, P.A. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8138793699
Plan sponsor’s address 4129 N. ARMENIA AVENUE, TAMPA, FL, 33607
TAMPA LUNG SPECIALISTS, P. A. 401(K) PROFIT SHARING PLAN 2021 680498643 2022-09-08 TAMPA LUNG SPECIALISTS, P.A. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8138793699
Plan sponsor’s address 4129 N. ARMENIA AVENUE, TAMPA, FL, 33607
TAMPA LUNG SPECIALISTS, P. A. 401(K) PROFIT SHARING PLAN 2020 680498643 2021-10-15 TAMPA LUNG SPECIALISTS, P.A. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8138793699
Plan sponsor’s address 4129 N. ARMENIA AVENUE, TAMPA, FL, 33607
TAMPA LUNG SPECIALISTS, P. A. 401(K) PLAN 2020 680498643 2023-10-04 TAMPA LUNG SPECIALISTS, P.A. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8138793699
Plan sponsor’s address 4129 N. ARMENIA AVENUE, TAMPA, FL, 33607
TAMPA LUNG SPECIALISTS, P. A. 401(K) PROFIT SHARING PLAN 2019 680498643 2020-10-14 TAMPA LUNG SPECIALISTS, P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8137777823
Plan sponsor’s address 4129 N. ARMENIA AVENUE, TAMPA, FL, 33607
TAMPA LUNG SPECIALISTS, P.A. 401(K) PLAN 2013 680498643 2014-06-17 TAMPA LUNG SPECIALISTS, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8138793699
Plan sponsor’s address 4129 N. ARMENIA AVENUE, TAMPA, FL, 336076493

Signature of
Role Plan administrator
Date 2014-06-17
Name of individual signing ADAM S. KATZ
Valid signature Filed with authorized/valid electronic signature
TAMPA LUNG SPECIALISTS, P.A. 401(K) PLAN 2012 680498643 2013-07-31 TAMPA LUNG SPECIALISTS, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8138793699
Plan sponsor’s address 4129 N. ARMENIA AVENUE, TAMPA, FL, 336076493

Signature of
Role Plan administrator
Date 2013-07-31
Name of individual signing ADAM S. KATZ
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
PERSANTE ROBERT Agent 2555 ENTERPRISE ROAD, CLEARWATER, FL, 33763

Director

Name Role Address
SIERRA KEVIN P Director 4129 NORTH ARMENIA AVENUE STE B, TAMPA, FL, 33607
KATZ ADAM S Director 4129 NORTH ARMENIA AVENUE STE B, TAMPA, FL, 33607
Bentley Nanette Director 4129 NORTH ARMENIA AVENUE STE B, TAMPA, FL, 33607
Cooperman Jonathan Director 4129 NORTH ARMENIA AVENUE STE B, TAMPA, FL, 33607

Related by officers

KATZ ADAM S

ADAM S. KATZ, M.D., P.A.

PERSANTE ROBERT

ALBINSON, PERSANTE & MCCORMACK, P.A. THE FOUNDATION FOR DISPUTE RESOLUTION, INC. YOUR PERSONAL BILLINGS, INC. ERIC BUEL AND ASSOCIATES, INC. AKITA SECURITY SYSTEMS, INC. KAILEE GORDON, INC. DAVID T. ROWLANDS, JR., M.D., P.A. SUNCOAST MICROWAVE, INC. PERSANTE & MCCORMACK, P.A. SEA COAST HOLDINGS, INC.

Related by address

No related companies by address

Date of last update: 03 Jan 2025

Sources: Florida Department of State

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