| Entity Name: | CENTER FOR INTERNAL MEDICINE, INC. - TEMPLE TERRACE |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 28 Oct 2010 (14 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P10000088743 |
| FEI/EIN Number | 273830522 |
| Address: | 4941 EAST BUSCH BLVD., SUITE #140, TAMPA, FL, 33617, US |
| Mail Address: | 4925 INDEPENDENCE PKWY, SUITE #155, TAMPA, FL, 33634, US |
| ZIP code: | 33617 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376848887 | 2011-01-13 | 2011-09-21 | 4941 EAST BUSCH BLVD,, SUITE #140, TEMPLE TERRACE, TAMPA, FL, 33617, US | 4941 E BUSCH BLVD, SUITE #140, TAMPA, FL, 336176056, US | |||||||||||||||||||
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| Phone | +1 813-985-2333 |
| Fax | 8139898746 |
Authorized person
| Name | DR. IVETTE HERNANDEZ |
| Role | MEDICAL DIRECTOR |
| Phone | 8139852333 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME54314 |
| State | FL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| TRINITY PHYSICIANS LLC | Agent |
| Name | Role |
|---|---|
| TRINITY PHYSICIANS LLC | Director |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2014-05-16 | TRINITY PHYSICIANS, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-05-16 | 7424 COMMUNITY COURT, HUDSON, FL 34667 | No data |
| CHANGE OF MAILING ADDRESS | 2012-01-24 | 4941 EAST BUSCH BLVD., SUITE #140, TAMPA, FL 33617 | No data |
| ARTICLES OF CORRECTION | 2010-11-24 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2014-05-16 |
| AMENDED ANNUAL REPORT | 2014-05-15 |
| ANNUAL REPORT | 2014-01-13 |
| ANNUAL REPORT | 2013-02-08 |
| ANNUAL REPORT | 2012-01-24 |
| ANNUAL REPORT | 2011-01-19 |
| Articles of Correction | 2010-11-24 |
| Domestic Profit | 2010-10-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
