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DAVID HERSON MD PA

Company Details

Entity Name: DAVID HERSON MD PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 03 Aug 2009 (16 years ago)
Document Number: P09000065367
FEI/EIN Number 270662645
Address: 14701 CROYDEN PLACE, TAMPA, FL, 33618, US
Mail Address: 14701 CROYDEN PLACE, TAMPA, FL, 33618, US
ZIP code: 33618
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1356573489 2009-08-24 2009-08-24 14701 CROYDON PL, TAMPA, FL, 336182160, US 21756 STATE ROAD 54, SUITE 102A, LUTZ, FL, 335492905, US

Contacts

Phone +1 813-443-5817
Fax 8134435818

Authorized person

Name DAVID M HERSON
Role OWNER
Phone 8134435817

Taxonomy

Taxonomy Code 207LP2900X - Pain Medicine (Anesthesiology) Physician
Is Primary Yes

Agent

Name Role Address
HERSON DAVID Agent 14701 CROYDEN PLACE, TAMPA, FL, 33618

President

Name Role Address
HERSON DAVID President 14701 CROYDON PLACE, TAMPA, FL, 33618

Documents

Name Date
ANNUAL REPORT 2024-03-26
ANNUAL REPORT 2023-02-18
ANNUAL REPORT 2022-01-29
ANNUAL REPORT 2021-02-09
ANNUAL REPORT 2020-03-16
ANNUAL REPORT 2019-03-06
ANNUAL REPORT 2018-04-24
ANNUAL REPORT 2017-03-11
ANNUAL REPORT 2016-03-04
ANNUAL REPORT 2015-03-16

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3573667702 2020-05-01 0455 PPP 21756 State Road 54 Suite 102A, Lutz, FL, 33549
Loan Status Date 2021-06-18
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 20833.34
Loan Approval Amount (current) 20833.34
Undisbursed Amount 0
Franchise Name -
Lender Location ID 529050
Servicing Lender Name Square Capital, LLC
Servicing Lender Address 1455 Market Street, Suite 600, San Francisco, CA, 94103
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Lutz, HILLSBOROUGH, FL, 33549-0005
Project Congressional District FL-15
Number of Employees 1
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 223542
Originating Lender Name Celtic Bank Corporation
Originating Lender Address SALT LAKE CITY, UT
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 21043.39
Forgiveness Paid Date 2021-05-05

Date of last update: 02 Feb 2025

Sources: Florida Department of State