| Entity Name: | ADVANCED INTERGRATED MEDICINE, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 Apr 2010 (15 years ago) |
| Document Number: | P10000033876 |
| FEI/EIN Number | 272314189 |
| Address: | 4002 W Obispo St, Tampa, FL, 33629, US |
| Mail Address: | Po Box 320848, Tampa, FL, 33679, US |
| ZIP code: | 33629 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164733861 | 2010-06-28 | 2020-08-27 | PO BOX 320848, TAMPA, FL, 336792848, US | 119 OAKFIELD DR, BRANDON, FL, 335115779, US | |||||||||||||||||||||||||||
|
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| Phone | +1 855-421-2733 |
| Fax | 3212802479 |
| Fax | 8133740491 |
Authorized person
| Name | JAMES C ABRAHAM |
| Role | OWNER |
| Phone | 8554212733 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME94672 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 274616600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| james abraham | Agent | 4002 W Obispo St, Tampa, FL, 33629 |
| Name | Role | Address |
|---|---|---|
| ABRAHAM JAMES C | President | PO Box 320848, Tampa, FL, 33679 |
| Name | Role | Address |
|---|---|---|
| ABRAHAM JAMES C | Director | PO Box 320848, Tampa, FL, 33679 |
| Name | Role | Address |
|---|---|---|
| ABRAHAM JAMES C | Vice President | PO Box 320848, Tampa, FL, 33679 |
| Name | Role | Address |
|---|---|---|
| ABRAHAM JAMES C | Secretary | PO Box 320848, Tampa, FL, 33679 |
| Name | Role | Address |
|---|---|---|
| ABRAHAM JAMES C | Treasurer | PO Box 320848, Tampa, FL, 33679 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-01-05 | 4002 W Obispo St, Tampa, FL 33629 | No data |
| CHANGE OF MAILING ADDRESS | 2017-01-05 | 4002 W Obispo St, Tampa, FL 33629 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-01-05 | 4002 W Obispo St, Tampa, FL 33629 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-01-16 | james, abraham | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-22 |
| ANNUAL REPORT | 2023-02-03 |
| ANNUAL REPORT | 2022-01-18 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-01-20 |
| ANNUAL REPORT | 2018-02-11 |
| ANNUAL REPORT | 2017-01-05 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
