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TRACI THOMPSON, M.D., P.A. - Florida Company Profile

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Company Details

Entity Name: TRACI THOMPSON, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 22 Jul 2020 (5 years ago)
Document Number: P20000054476
FEI/EIN Number 852153112
Mail Address: 12191 W. LINEBAUGH AVE., UNIT 186, TAMPA, FL, 33626, US
Address: 904 EAST HENRY AVENUE, TAMPA, FL, 33604, US
ZIP code: 33604
City: Tampa
County: Hillsborough
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
THOMPSON TRACI President 12191 W. LINEBAUGH AVE., TAMPA, FL, 33626
Thompson Traci Agent 904 EAST HENRY AVENUE, TAMPA, FL, 33604

U.S. Small Business Administration Profile

Phone Number:
E-mail Address:
Contact Person:
TRACI THOMPSON
Ownership and Self-Certifications:
Black American, Other Minority Owned, Self-Certified Small Disadvantaged Business, Women-Owned Small Business, Woman Owned
User ID:
P2927717

Unique Entity ID

Unique Entity ID:
PVYNZFDVCYP8
CAGE Code:
9E8V2
UEI Expiration Date:
2026-05-04

Business Information

Activation Date:
2025-05-08
Initial Registration Date:
2022-07-27

National Provider Identifier

NPI Number:
1043984875
Certification Date:
2021-08-09

Authorized Person:

Name:
DR. TRACI THOMPSON
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
852153112
Plan Year:
2024
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
0
Sponsors Telephone Number:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G20000092785 PAPILLON CONSULTING ACTIVE 2020-07-31 2025-12-31 - 12157 W. LINEBAUGH AVENUE, UNIT 186, TAMPA, FL, 33626

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2023-03-06 904 EAST HENRY AVENUE, TAMPA, FL 33604 -
REGISTERED AGENT NAME CHANGED 2022-02-20 Thompson, Traci -
CHANGE OF PRINCIPAL ADDRESS 2021-07-26 904 EAST HENRY AVENUE, TAMPA, FL 33604 -
CHANGE OF MAILING ADDRESS 2021-02-03 904 EAST HENRY AVENUE, TAMPA, FL 33604 -

Documents

Name Date
ANNUAL REPORT 2024-02-29
ANNUAL REPORT 2023-03-06
ANNUAL REPORT 2022-02-20
ANNUAL REPORT 2021-02-03
Domestic Profit 2020-07-22

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Date of last update: 02 Jul 2025

Sources: Florida Department of State