| Entity Name: | GASTROENTEROLOGY SPECIALISTS OF TAMPA BAY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 Jun 2005 (20 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P05000093385 |
| FEI/EIN Number | 203095097 |
| Address: | 6919 N. DALE MABRY HWY, SUITE 320, TAMPA, FL, 33614, US |
| Mail Address: | 6919 N. DALE MABRY HWY, SUITE 320, TAMPA, FL, 33614, US |
| ZIP code: | 33614 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790830800 | 2007-01-25 | 2008-06-24 | 3633 LITTLE RD, SUITE 104, TRINITY, FL, 346551815, US | 7171 N DALE MABRY HWY, SUITE 305, TAMPA, FL, 336142630, US | |||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 727-372-5547 |
| Fax | 7273725976 |
| Phone | +1 813-930-8816 |
| Fax | 8139321856 |
Authorized person
| Name | MRS. YOLANDA ROSARIO |
| Role | OFFICE SUPERVISOR |
| Phone | 8139308816 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME53996 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 275238700 |
| State | FL |
| Issuer | MEDICAID |
| Number | 275993400 |
| State | FL |
| Issuer | MEDICAID |
| Number | 275993401 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROSARIO ANGEL M | Agent | 6919 N. DALE MABRY HWY, TAMPA, FL, 33614 |
| Name | Role | Address |
|---|---|---|
| ROSARIO ANGEL | Director | 6919 N. DALE MABRY HWY, TAMPA, FL, 33614 |
| CRESPO ISRAEL | Director | 6919 N. DALE MABRY HWY, TAMPA, FL, 33614 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-01-20 | 6919 N. DALE MABRY HWY, SUITE 320, TAMPA, FL 33614 | No data |
| CHANGE OF MAILING ADDRESS | 2014-01-20 | 6919 N. DALE MABRY HWY, SUITE 320, TAMPA, FL 33614 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-20 | 6919 N. DALE MABRY HWY, SUITE 320, TAMPA, FL 33614 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-04-25 | ROSARIO, ANGEL M | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-06-28 |
| ANNUAL REPORT | 2017-02-16 |
| ANNUAL REPORT | 2016-01-15 |
| ANNUAL REPORT | 2015-01-14 |
| ANNUAL REPORT | 2014-01-20 |
| ANNUAL REPORT | 2013-03-19 |
| ANNUAL REPORT | 2012-02-14 |
| ANNUAL REPORT | 2011-01-11 |
| ANNUAL REPORT | 2010-04-29 |
| ANNUAL REPORT | 2009-04-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
