ACADEMIC MEDICAL GROUP INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- ACADEMIC MEDICAL GROUP INC (EIN 86-3038188)
- Tax period
- 2022-10-01 to 2023-09-30
- Filed
- 2024-08-15
- IRS object ID
- 202402289349301480
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-08-15T14:53:24-05:00 | ReturnTs |
| Tax Period End | 2023-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 W 5TH ST SUITE 800 | AddressLine1Txt |
| City | WINSTONSALEM | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 863038188 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ACADEMIC MEDICAL GROUP INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ACAD | BusinessNameControlTxt |
| Phone | 8778295500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 TAMPA GENERAL CIR | AddressLine1Txt |
| City | TAMPA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33606 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK RUNYON | PersonNm |
| Person Title | TREASURER & DIRECTOR | PersonTitleTxt |
| Phone | 8778295500 | PhoneNum |
| Signature | 2024-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WHITNEY B HEBRON | PreparerPersonNm |
| PTIN | P01226647 | PTIN |
| Phone | 3362753394 | PhoneNum |
| Preparation | 2024-07-29 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2024-08-08 14:25:15Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHARLES LOCKWOOD MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 TAMPA GENERAL CIR | AddressLine1Txt |
| City | TAMPA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $0 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2020 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 1915 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $0 | PYTotalRevenueAmt |
| CY Total Revenue | $0 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,024,215 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $242,556 | PYOtherExpensesAmt |
| CY Other Expenses | -$9,024,215 | CYOtherExpensesAmt |
| PY Total Expenses | $242,556 | PYTotalExpensesAmt |
| CY Total Expenses | $0 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$242,556 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $0 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $23,230,435 | TotalAssetsBOYAmt |
| Total Assets EOY | $44,227,018 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $23,372,991 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $44,369,574 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$142,556 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$142,556 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AMG WAS FORMED FOR THE PURPOSE OF COLLABORATION BETWEEN THE TAX-EXEMPT ENTITIES, FHSC AND USF, AND THEIR RESPECTIVE AFFILIATES. THAT PURPOSE INCLUDES COORDINATION OF THE INTEGRATED CLINICAL SERVICES OF PHYSICIANS AND ADVANCED PRACTICE PROVIDERS EMPLOYED BY USF AND TAMPA GENERAL MEDICAL GROUP, INC. ("TGMG"), AN AFFILIATE OF FHSC, AND THEIR RESPECTIVE AFFILIATES, IN ORDER TO EXPAND THE AVAILABILITY AND IMPROVE THE QUALITY OF PROFESSIONAL MEDICAL SERVICES IN WEST CENTRAL FLORIDA AND TO PROMOTE PUBLIC HEALTH, CONSISTENT WITH THE CHARITABLE, EDUCATIONAL, SCIENTIFIC, AND MEDICAL PURPOSES OF THE ORGANIZATIONS. AMG WILL PROVIDE SUPPORT SERVICES INCLUDING MANAGEMENT, OPERATIONAL, ADMINISTRATIVE, AND PRACTICE INFRASTRUCTURE SERVICES FOR TGMG, USF, AND ANY OF THEIR AFFILIATED ENTITIES IN FURTHERANCE OF FHSC AND USF'S SHARED MISSIONS. IN EXCHANGE FOR AMG'S SUPPORT SERVICES, TGMG AND USF WILL EACH PAY A FAIR MARKET VALUE FEE FOR THE SERVICES THEY RECEIVE FROM AMG. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | -$812,656 | ExpenseAmt |
| Desc | 1. FACILITATE THE EXPANSION OF AVAILABILITY AND IMPROVEMENT OF THE QUALITY OF PROFESSIONAL MEDICAL SERVICES IN WEST CENTRAL FLORIDA2. PROMOTE PUBLIC HEALTH, CONSISTENT WITH THE CHARITABLE, EDUCATIONAL, SCIENTIFIC AND MEDICAL PURPOSES OF FHSC AND USF. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | N/A | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | N/A | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | -$812,656 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 16 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1915 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | 0 | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LIJAH LOKENAUTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8138447000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 TAMPA GENERAL CIR | AddressLine1Txt |
| City | TAMPA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33606 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| CHARLES LOCKWOOD MD | |||||||
| CHAIRMAN/CHIEF EXECUTIVE & DIRECTOR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JOHN COURIS | |||||||
| SECRETARY & DIRECTOR | 1.00 | 49.00 | Yes (X) | Yes (X) | $0 | $2,113,230 | $41,496 |
| STACEY BRANDT | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $762,222 | $41,496 | |
| RAJENDRA BALIGA MD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JUDETTE LOUIS MD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MARK RUNYON | |||||||
| TREASURER & DIRECTOR | 1.00 | 49.00 | Yes (X) | Yes (X) | $0 | $911,936 | $35,040 |
| ADAM SMITH | |||||||
| DIRECTOR | 1.00 | 49.00 | Yes (X) | $0 | $687,361 | $40,888 | |
| RICH SOBIERAY | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MARK MOSELEY MD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| STEVE CURRALL PHD | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,474,749 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $158,920 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| UNIVERSITY MEDICAL SERVICE ASSOCIATION I | |||||
| PO BOX 917492 | ORLANDO | FL | 328917492 | MEDICAL SERVICES | $3,033,278 |
| BDO USA LLP | |||||
| PO BOX 642743 | PITTSBURGH | PA | 15264 | PROFESSIONAL SERVICES | $158,779 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,617 | TotalAmt |
| Program Services | $39,617 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,648,820 | TotalAmt |
| Program Services | $2,121,705 | ProgramServicesAmt |
| Management And General | $527,115 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,335,778 | TotalAmt |
| Program Services | $5,074,958 | ProgramServicesAmt |
| Management And General | $1,260,820 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,732 | TotalAmt |
| Program Services | $16,643 | ProgramServicesAmt |
| Management And General | $103,089 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $899,865 | TotalAmt |
| Program Services | $539,062 | ProgramServicesAmt |
| Management And General | $360,803 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $680 | TotalAmt |
| Program Services | $348 | ProgramServicesAmt |
| Management And General | $332 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,576 | TotalAmt |
| Program Services | $52,061 | ProgramServicesAmt |
| Management And General | $14,515 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,868 | TotalAmt |
| Program Services | $1,370 | ProgramServicesAmt |
| Management And General | $6,498 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| EMPLOYEE LEASING AGREEM | $2,158,645 | $715,591 | $1,443,054 |
| PURCH SVCS - MGMT AGREE | $1,141,918 | $378,546 | $763,372 |
| DUES AND MEMBERSHIPS | $237,311 | $47,453 | $189,858 |
| REIMBURSED EXPENSES | -$13,702,567 | -$9,815,177 | -$3,887,390 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,757 | TotalAmt |
| Program Services | $15,167 | ProgramServicesAmt |
| Management And General | $30,590 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | -$812,656 | ProgramServicesAmt |
| Management And General | $812,656 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,313,708 | BOYAmt |
| EOY | $2,592,888 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,021,654 | BOYAmt |
| EOY | $15,451,778 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,222 | BOYAmt |
| EOY | $110,222 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,784,851 | BOYAmt |
| EOY | $26,072,130 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,230,435 | BOYAmt |
| EOY | $44,227,018 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,372,991 | BOYAmt |
| EOY | $44,369,574 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,372,991 | BOYAmt |
| EOY | $44,369,574 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$142,556 | BOYAmt |
| EOY | -$142,556 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$142,556 | BOYAmt |
| EOY | -$142,556 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,230,435 | BOYAmt |
| EOY | $44,227,018 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $0 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 2 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| FLORIDA HEALTH SCIENCES CENTER INC | ||||
| 593458145 | 3 | Yes (1) | $0 | $0 |
| UNIVERSITY OF SOUTH FLORIDA | ||||
| 592684166 | 2 | Yes (1) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE FROM AFFILIATES | Desc |
| Book Value | $26,072,130 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $26,072,130 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AMG APPLIES FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS AND PROVIDES GUIDANCE WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUE OF THESE POSITIONS ARE DETERMINED. U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (U.S. GAAP) REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINABLE UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN COURIS | ||||||||||||||
| SECRETARY & DIRECTOR | $0 | $1,231,255 | $0 | $881,975 | $0 | $0 | $0 | $15,250 | $0 | $26,246 | $0 | $2,154,726 | $0 | $0 |
| MARK RUNYON | ||||||||||||||
| TREASURER & DIRECTOR | $0 | $650,924 | $0 | $261,012 | $0 | $0 | $0 | $13,006 | $0 | $22,034 | $0 | $946,976 | $0 | $0 |
| STACEY BRANDT | ||||||||||||||
| DIRECTOR | $0 | $500,136 | $0 | $261,306 | $0 | $780 | $0 | $15,250 | $0 | $26,246 | $0 | $803,718 | $0 | $0 |
| ADAM SMITH | ||||||||||||||
| DIRECTOR | $0 | $395,005 | $0 | $243,498 | $0 | $48,858 | $0 | $15,250 | $0 | $25,638 | $0 | $728,249 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | NON-FIXED PAYMENTS PROVIDED BONUS AND INCENTIVE COMPENSATION IS BASED ON ACHIEVEMENT OF CERTAIN TARGETS, QUALITY INDICATORS, AND NON-FINANCIAL METRICS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | COLLABORATION BETWEEN THE FLORIDA HEALTH SCIENCES CENTER AND UNIVERSITY OF SOUTH FLORIDA AND THEIR RESPECTIVE AFFILIATES. |
| FORM 990, PART III, LINE 3 | THE CORPORATION WAS FORMED TO PROVIDE CERTAIN SERVICES TO ASSIST THE PHYSICIANS EMPLOYED BY THE UNIVERSITY OF SOUTH FLORIDA BOARD OF TRUSTEES ("USF") AND TAMPA GENERAL MEDICAL GROUP, INC. ("TGMG"). THE CORPORATION'S BOARD OF DIRECTORS ARE COMPOSED OF REPRESENTATIVES OF UNIVERSITY OF SOUTH FLORIDA (USF) HEALTH SERVICES SUPPORT ORGANIZATION, INC. ("USF HSSO"), AN AFFILIATE OF USF, AND FLORIDA HEALTH SCIENCE CENTER, INC. D/B/A TAMPA GENERAL HOSPITAL ("FHSC"), AN AFFILIATE OF TGMG. THE OFFICERS FOR TGMG AND UNIVERSITY MEDICAL SERVICE ASSOCIATION, INC. ("UMSA"), A CONTROLLED AFFILIATE OF USF, WILL BE INVOLVED IN THE MANAGEMENT OF THE CORPORATION INDIRECTLY THROUGH THE CORPORATION'S PRESIDENT. THE OFFICERS OF TGMG AND UMSA WILL COLLABORATE WITH THE CORPORATION'S LEADERSHIP AND MAY HAVE AN INDIRECT INFLUENCE ON THE CORPORATION'S MANAGEMENT DECISIONS. THE GOVERNING BOARD OF THE CORPORATION CONSISTS OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF FHSC ("PRESIDENT") AND THE CHAIR OF USF HSSO, A CONTROLLED AFFILIATE OF USF ("CHAIR"). THE PRESIDENT AND CHAIR EACH APPOINT FOUR (4) ADDITIONAL DIRECTORS TO SERVE ON THE GOVERNING BOARD OF THE CORPORATION. THE NUMBER OF MEMBERS OF THE GOVERNING BOARD APPOINTED BY A TGH OR USF REPRESENTATIVE SHALL ALWAYS BE EQUAL. THE GOVERNING BOARD'S AUTHORITY INCLUDES (I) OVERSEEING THE FINANCIAL PERFORMANCE AND ESTABLISHING FINANCIAL METRICS AND TARGETS RELATING TO THE CORPORATION, (II) ESTABLISHING OVERHEAD FUNDING POLICIES FOR THE CORPORATION, (III) OVERSEEING THE OPERATING AND EXPENSE STRUCTURE OF THE CORPORATION, AND (IV) OVERSEEING INFRASTRUCTURE AND REVENUE CYCLE SERVICES PROVIDED BY THE CORPORATION IN SUPPORT OF ITS OPERATIONS. THE CORPORATION WILL PROVIDE SUPPORT SERVICES IN FURTHERANCE OF THE SUPPORTED ORGANIZATIONS' SHARED MISSIONS AND EXEMPT PURPOSES. THE CORPORATION WILL PROVIDE INTEGRAL SERVICES TO BOTH SUPPORTED ORGANIZATIONS, WHICH INCLUDE MANAGEMENT, ADMINISTRATIVE, ORGANIZATIONAL, AND PRACTICE INFRASTRUCTURE SERVICES. BUT FOR THE CORPORATION PROVIDING SUCH SERVICES, FHSC AND USF WOULD EACH HAVE TO PERFORM THE SERVICES THEMSELVES. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION'S SOLE MEMBER IS FLORIDA HEALTH SCIENCES CENTER INC (FHSC), A 501(C)(3) ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF AMG HAS TEN (10) DIRECTORS DIVIDED INTO THREE (3) CLASSES. CLASS 1 - SMT DIRECTORS: THREE DIRECTORS APPOINTED BY FLORIDA HEALTH SCIENCES CENTER INC (FHSC), COMPRISED OF MEMBERS OF THE SENIOR MANAGEMENT TEAM OF FHSC. CLASS 2 - COMMUNITY DIRECTORS: THREE DIRECTORS APPOINTED BY FHSC TO REPRESENT FHSC AND THE COMMUNITY. ONE OF THESE THREE DIRECTORS WILL ALSO BE A DIRECTOR OF FHSC. CLASS 3 - PHYSICIAN DIRECTORS: THREE DIRECTORS ELECTED BY THE PHYSICIANS OF TGMG. THE SMT AND COMMUNITY DIRECTORS SHALL BE APPOINTED BY FHSC AFTER RECEIVING THE RECOMMENDATIONS OF THE NOMINATING COMMITTEE. THE PHYSICIAN DIRECTORS SHALL BE ELECTED BY THE PHYSICIANS AFTER RECEIVING THE RECOMMENDATIONS OF THE NOMINATING COMMITTEE. ONLY PERSONS APPROVED BY THE NOMINATING COMMITTEE ARE ELIGIBLE TO SERVE AS DIRECTORS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS SUBJECT TO APPROVAL OF MEMBERS PER THE BYLAWS OF AMG. FLORIDA HEALTH SCIENCES CENTER INC (FHSC) IS THE SOLE MEMBER OF THE CORPORATION. AS SUCH, FHSC IS ENTITLED TO ALL RIGHTS AND POWERS OF A MEMBER UNDER THE LAWS OF THE STATE OF FLORIDA, AND THE ARTICLES OF INCORPORATION AND BYLAWS OF AMG. UNDER THE BYLAWS, CERTAIN POWERS ARE EXPRESSLY RESERVED TO FHSC: (A) ADOPT, AMEND, MODIFY OR RESTATE THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION, IN WHOLE OR IN PART; (B) APPROVE ANY AMENDMENT TO THE CORPORATION'S CHARITY OR DISCOUNTED CARE POLICIES; (C) INCUR ANY DEBT; (D) APPROVE THE CORPORATION ENTERING INTO ANY NEW SERVICE LINES; (E) APPOINT AND REMOVE THE COMMUNITY DIRECTORS AND SMT DIRECTORS, WITH OR WITHOUT CAUSE; (F) APPROVE THE ESTABLISHMENT OR DISSOLUTION OF ORGANIZATIONAL RELATIONSHIPS, INCLUDING SUBSIDIARY CORPORATIONS, PARTNERSHIPS, JOINT VENTURES, MERGERS AND CONSOLIDATIONS; (G) APPROVE THE MERGER, CONSOLIDATION, DISSOLUTION OR OTHER FUNDAMENTAL CORPORATE REORGANIZATION OF THE CORPORATION; AND (H) APPROVE THE ANNUAL CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DRAFT FORM 990 WAS REVIEWED AT THE REGULARLY SCHEDULED BOARD OF DIRECTOR MEETING IN JULY 2024. UPON APPROVAL BY THE BOARD, THE FORM 990 IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | AMG ADHERES TO THE CONFLICT OF INTEREST POLICY OF ITS SOLE MEMBER ENFORCEMENT OF CONFLICTS POLICY THE MONITORING AND ENFORCING OF THE CONFLICT OF INTEREST POLICY IS A JOINT EFFORT BETWEEN CORPORATE COMPLIANCE AND HUMAN RESOURCES. ALL NEW HIRES ARE REQUIRED TO REVIEW, COMPLETE, AND SIGN THE CONFLICT OF INTEREST (COI) STATEMENT. THE LEADERSHIP GROUP AND ALL BOARD MEMBERS ARE REQUIRED TO REVIEW, COMPLETE, AND SIGN THE COI ANNUALLY. IN ADDITION, EXISTING EMPLOYEES ARE REQUIRED AS PART OF THEIR ANNUAL PERFORMANCE EVALUATION TO REVIEW, COMPLETE, AND SIGN THE COI. ALL THE COIS ARE REVIEWED BY HUMAN RESOURCES. IF THERE IS A COI DISCLOSED ON THE FORM, ADDITIONAL INFORMATION IS REQUESTED FROM THE EMPLOYEE. IN SOME CASES, THE CORPORATE COMPLIANCE DEPARTMENT IS INVOLVED WHERE ADDITIONAL INPUT OR GUIDANCE IS NEEDED BY HUMAN RESOURCES. EMPLOYEES ARE ALSO ADVISED TO DISCLOSE COIS THAT MAY ARISE DURING THE COURSE OF THE YEAR. EMPLOYEES AND OTHER TGH HEALTHCARE PARTNERS CAN SIMILARLY REPORT COIS TO CORPORATE COMPLIANCE USING THE COMPLIANCE LINE, EMAIL, PHONE, ETC. PERIODICALLY, IN NEWSLETTERS ISSUED BY CORPORATE COMPLIANCE, REFERENCE IS MADE TO COI. IT IS THE RESPONSIBILITY OF CORPORATE COMPLIANCE TO INITIATE INVESTIGATIONS OF ALLEGATIONS OF COIS. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 539,062. MANAGEMENT AND GENERAL EXPENSES 360,803. TOTAL EXPENSES 899,865. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| FLORIDA HEALTH SCIENCES CENTER INC | |||||||||||
| PO BOX 1289 | TAMPA | FL | 336011289 | 593458145 | HOSPITAL | FL | 501(C)(3) | LINE 3 | N/A | 0 | |
| TAMPA GENERAL MEDICAL GROUP INC | |||||||||||
| PO BOX 1289 | TAMPA | FL | 33606 | 861810505 | PHYSICIAN | FL | 501(C)(3) | LINE 10 | 0 | FHSC | |
| TAMPA GENERAL PROVIDER NETWORK INC | |||||||||||
| 1 TAMPA GENERAL CIRCLE | TAMPA | FL | 33606 | 861810505 | PHYSICIAN | FL | 501(C)(3) | LINE 10 | 0 | FHSC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE SURGERY CENTER AT TGH BRANDON | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1289 | AddressLine1Txt |
| City | TAMPA | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 336011289 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 611795393 | EIN |
| Primary Activities | SURGERY CE | PrimaryActivitiesTxt |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TGH AMBULATORY SERVICES COMPANY | ||||||||||||||
| PO BOX 1289 | TAMPA | FL | 336011289 | 812203868 | HOLDING CO | FL | N/A | C | 0 | |||||
| TGHHOC | ||||||||||||||
| PO BOX 1289 | TAMPA | FL | 336011289 | 472089251 | RESTAURANT | FL | N/A | C | 0 | |||||
| FLORDIA HEALTH SCIENCES CENTER LTD | ||||||||||||||
| 980695992 | PROFESSION | N/A | C | 0 | 23 LIME TREE BAY AVENUE BLD 4 FL 2 | GRAND CAYMAN | CJ | KY1-1102 | CJ | |||||
| TGH INNOVENTURES BLOCKER LLC | ||||||||||||||
| PO BOX 1289 | TAMPA | FL | 33601 | 872558291 | INVESTING | DE | N/A | C | 0 | |||||
| TGPN BLOCKER LLC | ||||||||||||||
| PO BOX 1289 | TAMPA | FL | 33601 | 884018311 | HOLDING CO | FL | N/A | C | 0 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |