| Entity Name: | ATLANTIS CLINIC PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 14 Mar 1994 (31 years ago) |
| Document Number: | P94000019410 |
| FEI/EIN Number | 65-0476148 |
| Address: | 3705 TAMPA RD 22, OLDSMAR, FL 34677 |
| Mail Address: | 3705 TAMPA RD 22, OLDSMAR, FL 34677 |
| ZIP code: | 34677 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033959051 | 2024-05-28 | 2024-05-28 | 1530 4TH ST N, ST PETERSBURG, FL, 337044412, US | 1530 4TH ST N, ST PETERSBURG, FL, 337044412, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 727-821-8700 |
| Fax | 7278218770 |
Authorized person
| Name | HOWARD NELSON CHIPMAN |
| Role | MEDICAL DIRECTOR |
| Phone | 8134762321 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CHIPMAN, HOWARD NIII | Agent | 510 SHORE DR E, OLDSMAR, FL 34677 |
| Name | Role | Address |
|---|---|---|
| CHIPMAN, HOWARD | President | 3705 TAMPA RD STE 22, OLDSMAR, FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 1995-06-08 | 3705 TAMPA RD 22, OLDSMAR, FL 34677 | No data |
| CHANGE OF MAILING ADDRESS | 1995-06-08 | 3705 TAMPA RD 22, OLDSMAR, FL 34677 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J03900009548 | LAPSED | 03-6635-CC | CIR CT HILLSBOROUGH CO FL. | 2003-09-08 | 2008-09-22 | $17140.14 | LABORATORY CORPORATION OF AMERICA, 5610 WEST LASALLE STREET, TAMPA, FL 33607 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-04-08 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-03-14 |
| ANNUAL REPORT | 2020-06-15 |
| ANNUAL REPORT | 2019-03-18 |
| ANNUAL REPORT | 2018-02-03 |
| ANNUAL REPORT | 2017-04-04 |
| ANNUAL REPORT | 2016-01-24 |
| ANNUAL REPORT | 2015-02-24 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 9715347301 | 2020-05-02 | 0455 | PPP | 3705 TAMPA RD STE 22, OLDSMAR, FL, 34677-6346 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of last update: 02 Feb 2025
Sources: Florida Department of State
