| Entity Name: | EXCEPTIONAL CARE OF TAMPA, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 May 2007 (18 years ago) |
| Document Number: | P07000056672 |
| FEI/EIN Number | 260141133 |
| Address: | 14902 Winding Creek Court, TAMPA, FL, 33613, US |
| Mail Address: | 14902 Winding Creek Court, TAMPA, FL, 33613, US |
| ZIP code: | 33613 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124287065 | 2008-06-05 | 2011-12-16 | 14502 N DALE MABRY HWY, SUITE 200, TAMPA, FL, 336182075, US | 14502 N DALE MABRY HWY, SUITE 200, TAMPA, FL, 336182075, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-963-0618 |
| Fax | 8779966394 |
Authorized person
| Name | MS. BETTY C. KARP |
| Role | DIRECTOR/MANAGING PARTNER |
| Phone | 8139630618 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | 6887317-96 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | 6887317-98 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 6887317-98 |
| State | FL |
| Issuer | MEDICAID |
| Number | 6887317-96 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Lozano Tomas A | Agent | 14902 Winding Creek Court, TAMPA, FL, 33613 |
| Name | Role | Address |
|---|---|---|
| PIERCE LISA H | President | 17705 CURRIE FORD DR, LUTZ, FL, 33558 |
| Name | Role | Address |
|---|---|---|
| Lozano Tomas Sr. | Chief Operating Officer | 27334 Golf Course Loop, Wesley Chapel, FL, 33544 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-14 | Lozano, Tomas A | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-04-02 | 14902 Winding Creek Court, SUITE 102-C, TAMPA, FL 33613 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-05 | 14902 Winding Creek Court, SUITE 102-C, TAMPA, FL 33613 | No data |
| CHANGE OF MAILING ADDRESS | 2018-03-05 | 14902 Winding Creek Court, SUITE 102-C, TAMPA, FL 33613 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2022-02-28 |
| ANNUAL REPORT | 2021-01-03 |
| ANNUAL REPORT | 2020-04-02 |
| AMENDED ANNUAL REPORT | 2019-10-15 |
| ANNUAL REPORT | 2019-06-17 |
| ANNUAL REPORT | 2018-03-05 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-03-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
