| Entity Name: | ATHENA L VALENCIA MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 Apr 2005 (20 years ago) |
| Document Number: | P05000048678 |
| FEI/EIN Number | 202600597 |
| Address: | 8702 BAY LAUREL COURT, TAMPA, FL, 33647 |
| Mail Address: | 8702 BAY LAUREL COURT, TAMPA, FL, 33647 |
| ZIP code: | 33647 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770750705 | 2008-05-09 | 2008-05-09 | 2726 WINDGUARD CIR, STE 101, WESLEY CHAPEL, FL, 335447361, US | 8702 BAY LAUREL CT, TAMPA, FL, 336472280, US | |||||||||||||||||||||||||
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| Phone | +1 813-973-8167 |
| Fax | 8139917654 |
Authorized person
| Name | ATHENA L VALENCIA |
| Role | MD/OWNER |
| Phone | 8139738167 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME66946 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA MEDICAL LICENSE |
| Number | ME66946 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VALENCIA ATHENA L | Agent | 8702 BAY LAUREL COURT, TAMPA, FL, 33647 |
| Name | Role | Address |
|---|---|---|
| VALENCIA ATHENA L | President | 8702 BAY LAUREL COURT, TAMPA, FL, 33647 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-30 |
| ANNUAL REPORT | 2023-04-15 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-03-10 |
| ANNUAL REPORT | 2020-03-21 |
| ANNUAL REPORT | 2019-04-14 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-04-17 |
| ANNUAL REPORT | 2016-03-07 |
| ANNUAL REPORT | 2015-03-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
