| Entity Name: | TAMPA BAY ARTIFICIAL LIMBS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Aug 1999 (25 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 10 Oct 2011 (13 years ago) |
| Document Number: | P99000072412 |
| FEI/EIN Number | 593593627 |
| Address: | 5109 N ARMENIA AVE, TAMPA, FL, 33603, US |
| Mail Address: | 5109 N ARMENIA AVE, TAMPA, FL, 33603, US |
| ZIP code: | 33603 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679519243 | 2006-06-21 | 2020-04-14 | 5109 N ARMENIA AVE, TAMPA, FL, 336031405, US | 5109 N ARMENIA AVE, TAMPA, FL, 336031405, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-801-9110 |
| Fax | 8138019048 |
Authorized person
| Name | ROBERT MANIERE |
| Role | PRESIDENT |
| Phone | 8138019110 |
Taxonomy
| Taxonomy Code | 335E00000X - Prosthetic/Orthotic Supplier |
| License Number | PRO 25 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025328600 |
| State | FL |
| Issuer | STAYWELL |
| Number | 290808 |
| State | FL |
| Issuer | AETNA EPDB PIN # |
| Number | 7376145 |
| State | FL |
| Issuer | TAMPA VA VENDOR # |
| Number | V516P-7063 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD FL |
| Number | R9100 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TAMPA BAY ARTIFICIAL LIMBS INC 401(K) PROFIT SHARING PLAN & TRUST | 2019 | 593593627 | 2020-04-20 | TAMPA BAY ARTIFICIAL LIMBS INC | 3 | |||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2020-04-20 |
| Name of individual signing | WALDO O ESPARZA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8138019110 |
| Plan sponsor’s address | 5109 N ARMENIA AVE, TAMPA, FL, 33603 |
Signature of
| Role | Plan administrator |
| Date | 2019-04-25 |
| Name of individual signing | WALDO O ESPARZA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8138019110 |
| Plan sponsor’s address | 5109 N ARMENIA AVE, TAMPA, FL, 33603 |
Signature of
| Role | Plan administrator |
| Date | 2018-07-24 |
| Name of individual signing | WALDO ESPARZA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8138019110 |
| Plan sponsor’s address | 5109 N ARMENIA AVE, TAMPA, FL, 33603 |
Signature of
| Role | Plan administrator |
| Date | 2017-05-05 |
| Name of individual signing | WALDO ESPARZA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8138019110 |
| Plan sponsor’s address | 5109 N ARMENIA AVE, TAMPA, FL, 33603 |
Signature of
| Role | Plan administrator |
| Date | 2016-06-22 |
| Name of individual signing | WALDO ESPARZA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8138019110 |
| Plan sponsor’s address | 5109 N ARMENIA AVE, TAMPA, FL, 33603 |
Signature of
| Role | Plan administrator |
| Date | 2015-06-05 |
| Name of individual signing | WALDO ESPARZA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8138019110 |
| Plan sponsor’s address | 5109 N ARMENIA AVE, TAMPA, FL, 33603 |
Signature of
| Role | Plan administrator |
| Date | 2014-06-12 |
| Name of individual signing | WALDO ESPARZA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8138019110 |
| Plan sponsor’s address | 5109 N ARMENIA AVE, TAMPA, FL, 33603 |
Signature of
| Role | Plan administrator |
| Date | 2013-06-07 |
| Name of individual signing | TAMPA BAY ARTIFICIAL LIMBS INC |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8138019110 |
| Plan sponsor’s address | 5109 N ARMENIA AVE, TAMPA, FL, 33603 |
Plan administrator’s name and address
| Administrator’s EIN | 593593627 |
| Plan administrator’s name | TAMPA BAY ARTIFICIAL LIMBS INC |
| Plan administrator’s address | 5109 N ARMENIA AVE, TAMPA, FL, 33603 |
| Administrator’s telephone number | 8138019110 |
Signature of
| Role | Plan administrator |
| Date | 2012-05-09 |
| Name of individual signing | TAMPA BAY ARTIFICIAL LIMBS INC |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8138019110 |
| Plan sponsor’s address | 5109 W ARMENIA AVE, TAMPA, FL, 336030000 |
Plan administrator’s name and address
| Administrator’s EIN | 593593627 |
| Plan administrator’s name | TAMPA BAY ARTIFICIAL LIMBS INC |
| Plan administrator’s address | 5109 W ARMENIA AVE, TAMPA, FL, 336030000 |
| Administrator’s telephone number | 8138019110 |
Signature of
| Role | Plan administrator |
| Date | 2011-05-11 |
| Name of individual signing | TAMPA BAY ARTIFICIAL LIMBS INC |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Gomez Maria P | Agent | 5109 N ARMENIA AVE, TAMPA, FL, 33603 |
| Name | Role | Address |
|---|---|---|
| Gomez Maria P | Owner | 5109 N ARMENIA AVE, TAMPA, FL, 33603 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000097916 | MANIFEST PROSTHETICS AND ORTHOTICS | ACTIVE | 2023-08-22 | 2028-12-31 | No data | 5109 N ARMENIA AVE., TAMPA, FL, 33603 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-08-22 | Gomez, Maria Paula | No data |
| REINSTATEMENT | 2011-10-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| AMENDMENT | 2009-07-07 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-03-26 | 5109 N ARMENIA AVE, TAMPA, FL 33603 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-03-17 | 5109 N ARMENIA AVE, TAMPA, FL 33603 | No data |
| CHANGE OF MAILING ADDRESS | 2006-03-17 | 5109 N ARMENIA AVE, TAMPA, FL 33603 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| AMENDED ANNUAL REPORT | 2023-08-22 |
| ANNUAL REPORT | 2023-03-16 |
| ANNUAL REPORT | 2022-01-25 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-30 |
| ANNUAL REPORT | 2019-01-29 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-03-01 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PURCHASE ORDER | AWARD | 36C24825P0258 | 2024-11-13 | 2024-12-12 | 2025-01-12 | |||||||||||||||||||||||||
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| Obligated Amount | 88462.69 |
| Current Award Amount | 88462.69 |
| Potential Award Amount | 88462.69 |
Description
| Title | LIMB PROSTHESIS |
| NAICS Code | 339113: SURGICAL APPLIANCE AND SUPPLIES MANUFACTURING |
| Product and Service Codes | 6515: MEDICAL AND SURGICAL INSTRUMENTS, EQUIPMENT, AND SUPPLIES |
Recipient Details
| Recipient | TAMPA BAY ARTIFICIAL LIMBS INC. |
| UEI | G9PMTJ3LUPX4 |
| Recipient Address | UNITED STATES, 5109 N ARMENIA AVE, TAMPA, HILLSBOROUGH, FLORIDA, 336031405 |
| Unique Award Key | CONT_AWD_36C24824P2196_3600_-NONE-_-NONE- |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 21460.40 |
| Current Award Amount | 21460.40 |
| Potential Award Amount | 21460.40 |
Description
| Title | ABOVE KNEE PROSTHESIS |
| NAICS Code | 339113: SURGICAL APPLIANCE AND SUPPLIES MANUFACTURING |
| Product and Service Codes | 6515: MEDICAL AND SURGICAL INSTRUMENTS, EQUIPMENT, AND SUPPLIES |
Recipient Details
| Recipient | TAMPA BAY ARTIFICIAL LIMBS INC. |
| UEI | G9PMTJ3LUPX4 |
| Recipient Address | UNITED STATES, 5109 N ARMENIA AVE, TAMPA, HILLSBOROUGH, FLORIDA, 336031405 |
| Unique Award Key | CONT_AWD_36C24824P2047_3600_-NONE-_-NONE- |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 10050.60 |
| Current Award Amount | 10050.60 |
| Potential Award Amount | 10050.60 |
Description
| Title | LIMB |
| NAICS Code | 339113: SURGICAL APPLIANCE AND SUPPLIES MANUFACTURING |
| Product and Service Codes | 6515: MEDICAL AND SURGICAL INSTRUMENTS, EQUIPMENT, AND SUPPLIES |
Recipient Details
| Recipient | TAMPA BAY ARTIFICIAL LIMBS INC. |
| UEI | G9PMTJ3LUPX4 |
| Recipient Address | UNITED STATES, 5109 N ARMENIA AVE, TAMPA, HILLSBOROUGH, FLORIDA, 336031405 |
| Unique Award Key | CONT_AWD_36C24824P1938_3600_-NONE-_-NONE- |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 11595.41 |
| Current Award Amount | 11595.41 |
| Potential Award Amount | 11595.41 |
Description
| Title | PROSTHESIS |
| NAICS Code | 339113: SURGICAL APPLIANCE AND SUPPLIES MANUFACTURING |
| Product and Service Codes | 6515: MEDICAL AND SURGICAL INSTRUMENTS, EQUIPMENT, AND SUPPLIES |
Recipient Details
| Recipient | TAMPA BAY ARTIFICIAL LIMBS INC. |
| UEI | G9PMTJ3LUPX4 |
| Recipient Address | UNITED STATES, 5109 N ARMENIA AVE, TAMPA, HILLSBOROUGH, FLORIDA, 336031405 |
| Unique Award Key | CONT_AWD_36C24824P1314_3600_-NONE-_-NONE- |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 22508.61 |
| Current Award Amount | 22508.61 |
| Potential Award Amount | 22508.61 |
Description
| Title | LIMB |
| NAICS Code | 339113: SURGICAL APPLIANCE AND SUPPLIES MANUFACTURING |
| Product and Service Codes | 6515: MEDICAL AND SURGICAL INSTRUMENTS, EQUIPMENT, AND SUPPLIES |
Recipient Details
| Recipient | TAMPA BAY ARTIFICIAL LIMBS INC. |
| UEI | G9PMTJ3LUPX4 |
| Recipient Address | UNITED STATES, 5109 N ARMENIA AVE, TAMPA, HILLSBOROUGH, FLORIDA, 336031405 |
| Unique Award Key | CONT_AWD_36C24824P1467_3600_-NONE-_-NONE- |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 15182.84 |
| Current Award Amount | 15182.84 |
| Potential Award Amount | 15182.84 |
Description
| Title | LIMB |
| NAICS Code | 339113: SURGICAL APPLIANCE AND SUPPLIES MANUFACTURING |
| Product and Service Codes | 6515: MEDICAL AND SURGICAL INSTRUMENTS, EQUIPMENT, AND SUPPLIES |
Recipient Details
| Recipient | TAMPA BAY ARTIFICIAL LIMBS INC. |
| UEI | G9PMTJ3LUPX4 |
| Recipient Address | UNITED STATES, 5109 N ARMENIA AVE, TAMPA, HILLSBOROUGH, FLORIDA, 336031405 |
| Unique Award Key | CONT_AWD_36C24824P1333_3600_-NONE-_-NONE- |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 81652.66 |
| Current Award Amount | 81652.66 |
| Potential Award Amount | 81652.66 |
Description
| Title | LIMB PROSTHESIS |
| NAICS Code | 339113: SURGICAL APPLIANCE AND SUPPLIES MANUFACTURING |
| Product and Service Codes | 6515: MEDICAL AND SURGICAL INSTRUMENTS, EQUIPMENT, AND SUPPLIES |
Recipient Details
| Recipient | TAMPA BAY ARTIFICIAL LIMBS INC. |
| UEI | G9PMTJ3LUPX4 |
| Recipient Address | UNITED STATES, 5109 N ARMENIA AVE, TAMPA, HILLSBOROUGH, FLORIDA, 336031405 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
