| Entity Name: | WILLIAM MACK, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Nov 1997 (27 years ago) |
| Document Number: | P97000100183 |
| FEI/EIN Number | 593486600 |
| Mail Address: | 933 ANCHORAGE ROAD, TAMPA, FL, 33602 |
| Address: | 3109 W AZEELE STREET, TAMPA, FL, 33609 |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669682399 | 2007-05-23 | 2011-11-07 | 3109 W. AZEELE STREET, TAMPA, FL, 33609, US | 3109 W. AZEELE STREET, TAMPA, FL, 33609, US | |||||||||||||||
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| Phone | +1 813-875-5437 |
| Fax | 8138739373 |
Authorized person
| Name | MR. WILLIAM PAUL MACK |
| Role | PRESIDENT |
| Phone | 8138755437 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MACK STEPHANIE | Agent | 3109 W. AZEELE STREET, TAMPA, FL, 33609 |
| Name | Role | Address |
|---|---|---|
| MACK WILLIAM P | President | 933 ANCHORAGE ROAD, TAMPA, FL, 33602 |
| Name | Role | Address |
|---|---|---|
| MACK STEPHANIE | Treasurer | 933 ANCHORAGE ROAD, TAMPA, FL, 33602 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000072558 | MACK CENTER: COSMETIC SURGERY- FACIAL & EYELID | ACTIVE | 2015-07-12 | 2025-12-31 | No data | 3109 W AZEELE STREET, TAMPA, FL, 33609 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-06-01 | MACK, STEPHANIE | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-06-01 | 3109 W. AZEELE STREET, TAMPA, FL 33609 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-01-14 | 3109 W AZEELE STREET, TAMPA, FL 33609 | No data |
| CHANGE OF MAILING ADDRESS | 2005-01-11 | 3109 W AZEELE STREET, TAMPA, FL 33609 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-11 |
| Reg. Agent Change | 2023-06-01 |
| ANNUAL REPORT | 2023-03-22 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-01-22 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-03-29 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-03-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
