| Entity Name: | TOMMIE BETANCOURT, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 May 2011 (14 years ago) |
| Date of dissolution: | 12 Jun 2015 (10 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 12 Jun 2015 (10 years ago) |
| Document Number: | P11000046310 |
| FEI/EIN Number | 452231921 |
| Address: | 13787 BELCHER ROAD SOUTH, SUITE 100, LARGO, FL, 33771, US |
| Mail Address: | 6717 BONNIE BAY CIRCLE, PINELLAS PARK, FL, 33781 |
| ZIP code: | 33771 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508144957 | 2011-08-02 | 2011-08-02 | 13787 BELCHER RD S, SUITE 100, LARGO, FL, 337714065, US | 13787 BELCHER RD S, SUITE 100, LARGO, FL, 337714065, US | |||||||||||||||||||
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| Phone | +1 727-535-9899 |
| Fax | 7275352818 |
Authorized person
| Name | DR. TOMMIE BETANCOURT |
| Role | PRESIDENT |
| Phone | 7277988298 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | OS11010 |
| State | FL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| ROTCHFORD & BETANCOURT, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| BETANCOURT TOMMIE L | President | 6717 BONNIE BAY CIR, PINELLAS PARK, FL, 33781 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000047026 | BAYSIDE INTERNAL MEDICINE, P.C. | EXPIRED | 2011-05-17 | 2016-12-31 | No data | 6717 BONNIE BAY CIR N, PINELLAS PARK, FL, 33781 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-06-12 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2012-01-06 | 13787 BELCHER ROAD SOUTH, SUITE 100, LARGO, FL 33771 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2015-06-12 |
| ANNUAL REPORT | 2014-03-20 |
| ANNUAL REPORT | 2013-04-22 |
| ANNUAL REPORT | 2012-01-06 |
| FEI UPDATE | 2011-05-22 |
| Domestic Profit | 2011-05-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
