| Entity Name: | PLANET HEALTH MEDICAL CENTER AT TAMPA CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Jul 2023 (2 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 17 Aug 2023 (a year ago) |
| Document Number: | P23000052514 |
| FEI/EIN Number | 932425922 |
| Address: | 5101 N. HABANA AVE, SUITE B, TAMPA, FL, 33614 |
| Mail Address: | 10305 NW 41 STREET STE 115, DORAL, FL, 33178, US |
| ZIP code: | 33614 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912780727 | 2023-08-15 | 2023-08-15 | 10305 NW 41ST ST STE 115, DORAL, FL, 331782975, US | 5101 N HABANA AVE, TAMPA, FL, 336146902, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 305-741-9281 |
| Phone | +1 813-537-2100 |
| Fax | 8135372400 |
Authorized person
| Name | DIANA J SANTISO |
| Role | VP |
| Phone | 3057419281 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SANTISO DIANA | Agent | 10305 NW 41 STREET STE 115, DORAL, FL, 33178 |
| Name | Role | Address |
|---|---|---|
| ROQUE NALANYS C | President | 10305 NW 41 STREET STE 115, DORAL, FL, 33178 |
| Name | Role | Address |
|---|---|---|
| SANTISO DIANA J | Vice President | 10305 NW 41 STREET STE 115, DORAL, FL, 33178 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2023-08-17 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-08-17 | 5101 N. HABANA AVE, SUITE B, TAMPA, FL 33614 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| Amendment | 2023-08-17 |
| Domestic Profit | 2023-07-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
