| Entity Name: | CARDIOTHORACIC SURGERY OF HYDE PARK, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Sep 2010 (14 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 21 Mar 2019 (6 years ago) |
| Document Number: | P10000077066 |
| FEI/EIN Number | 273178198 |
| Address: | 8950 Dr. Martin Luther King Jr. Street Nor, SUITE 102, Saint Petersburg, FL, 33702, US |
| Mail Address: | 301 W PLATT, #24, TAMPA, FL, 33606 |
| ZIP code: | 33702 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093024333 | 2010-10-05 | 2021-03-08 | 301 W PLATT ST, SUITE 24, TAMPA, FL, 336062292, US | 8950 9TH ST N STE 102, ST PETERSBURG, FL, 337023001, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-498-8898 |
| Fax | 7278006959 |
Authorized person
| Name | LEAH TEEKELL-TAYLOR |
| Role | OWNER/PROVIDER |
| Phone | 7274988898 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | No |
| Taxonomy Code | 207RI0011X - Interventional Cardiology Physician |
| Is Primary | No |
| Taxonomy Code | 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1790390011 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1912971292 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1982649935 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1609489541 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TEEKELL-TAYLOR LEAH M | Agent | 301 W. Platt Street, TAMPA, FL, 33606 |
| Name | Role | Address |
|---|---|---|
| TEEKELL-TAYLOR LEAH M | President | 301 W. Platt Street, TAMPA, FL, 33606 |
| Name | Role | Address |
|---|---|---|
| TEEKELL-TAYLOR LEAH M | Secretary | 301 W. Platt Street, TAMPA, FL, 33606 |
| Name | Role | Address |
|---|---|---|
| TEEKELL-TAYLOR LEAH M | Treasurer | 301 W. Platt Street, TAMPA, FL, 33606 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G25000013102 | DOCS! | ACTIVE | 2025-01-29 | 2030-12-31 | No data | 8950 MARTIN LUTHER KING JR. STREET NORTH, SUITE 102, ST. PETERSBURG, FL, 33702 |
| G22000050264 | KIDS OUTSIDE THE BOX! | ACTIVE | 2022-04-20 | 2027-12-31 | No data | 8950 DR. MARTIN LUTHER KING JR. STREET N, SUITE 102, ST. PETERSBURG, FL, 33702 |
| G21000060609 | FLORIDA CARDIAC THERAPEUTICS | ACTIVE | 2021-05-03 | 2026-12-31 | No data | 310 WEST PLATT STREET, #24, TAMPA, FL, 33606 |
| G12000065826 | MILLENNIUM HEALTH AND WELLNESS | EXPIRED | 2012-07-01 | 2017-12-31 | No data | 10033 9TH STREET NORTH, ST. PETERSBURG, FL, 33716 |
| G10000106720 | HYDE PARK CARDIOTHORACIC SURGERY, INC. | EXPIRED | 2010-12-03 | 2015-12-31 | No data | 301 W PLATT STREET, BOX #24, TAMPA, FL, 33606 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2019-03-21 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-03-22 | 8950 Dr. Martin Luther King Jr. Street North, SUITE 102, Saint Petersburg, FL 33702 | No data |
| REINSTATEMENT | 2014-09-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-05-20 | 301 W. Platt Street, Suite 24, TAMPA, FL 33606 | No data |
| CHANGE OF MAILING ADDRESS | 2011-03-16 | 8950 Dr. Martin Luther King Jr. Street North, SUITE 102, Saint Petersburg, FL 33702 | No data |
| ARTICLES OF CORRECTION | 2010-10-18 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-19 |
| ANNUAL REPORT | 2023-05-18 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-19 |
| Amendment | 2019-03-21 |
| ANNUAL REPORT | 2019-02-14 |
| ANNUAL REPORT | 2018-03-13 |
| ANNUAL REPORT | 2017-03-22 |
| ANNUAL REPORT | 2016-04-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
