| Entity Name: | TAMPA TRAUMA MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 20 Aug 2004 (20 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | P04000120812 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 5509 WEST GRAY STREET, 201, TAMPA, FL, 33609 |
| Mail Address: | P.O. BOX 260636, TAMPA, FL, 33685 |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063550481 | 2007-02-01 | 2020-08-22 | 4602 N ARMENIA AVE, SUITE D1, TAMPA, FL, 336032626, US | 4602 N ARMENIA AVE, SUITE D1, TAMPA, FL, 336032626, US | |||||||||||||||||||
|
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| Phone | +1 813-870-1900 |
| Fax | 8138701988 |
Authorized person
| Name | LUIS M AZAN |
| Role | MEDICAL DIRECTOR |
| Phone | 8138701900 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | HCC6118 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DANDAR THOMAS J | Agent | 5509 WEST GRAY STREET, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ YAISMEL | President | POST OFFICE BOX 260636, TAMPA, FL, 33685 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ YAISMEL | Director | POST OFFICE BOX 260636, TAMPA, FL, 33685 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| REINSTATEMENT | 2011-07-14 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2011-07-14 | 5509 WEST GRAY STREET, 201, TAMPA, FL 33609 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-07-14 | DANDAR, THOMAS J | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-07-14 | 5509 WEST GRAY STREET, SUITE 201, TAMPA, FL 33609 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-07-14 | 5509 WEST GRAY STREET, 201, TAMPA, FL 33609 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| AMENDMENT | 2007-04-30 | No data | No data |
| AMENDMENT | 2007-02-08 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J15000540696 | LAPSED | 05-CC-027646 | HILLSBOROUGH COUNTY COURT | 2014-06-16 | 2020-05-06 | $126,466.80 | STATE FARM FIRE AND CASUALTY COMPANY, ONE STATE FARM PLAZA, BLOOMINGTON, IL 61710-0001 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-03-04 |
| REINSTATEMENT | 2011-07-14 |
| Amendment | 2007-04-30 |
| Amendment | 2007-02-08 |
| ANNUAL REPORT | 2006-06-05 |
| ANNUAL REPORT | 2005-01-25 |
| Domestic Profit | 2004-08-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
