| Entity Name: | NATIVITY MEDICAL CENTER INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 13 Jul 1977 (48 years ago) |
| Document Number: | 539248 |
| FEI/EIN Number | 59-1751386 |
| Address: | 2931 SR 60 E, VALRICO, FL 33594 |
| Mail Address: | 2931 SR 60 E, VALRICO, FL 33594 |
| ZIP code: | 33594 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891860771 | 2006-11-23 | 2020-08-22 | 2931 STATE ROAD 60 E, VALRICO, FL, 335943416, US | 2931 STATE ROAD 60 E, VALRICO, FL, 335943416, US | |||||||||||||||||||||
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| Phone | +1 813-689-0904 |
| Fax | 8136897549 |
Authorized person
| Name | CELSA CASTRO |
| Role | ADMINISTRATOR |
| Phone | 8136890904 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0600474 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CASTRO, CELSA T. | Agent | 2931 SR 60 E, VALRICO, FL 33594 |
| Name | Role | Address |
|---|---|---|
| CASTRO, CELSA T. | STDP | 2931 SR 60 E, VALRICO, FL 33594 |
| Name | Role | Address |
|---|---|---|
| CASTRO-BALZER, CAROLYN | Director | 4441 KING EDWARD DR, ORLANDO, FL 32826 |
| CASTRO, LUIS P | Director | 2932 S.R. 60 E, VALRICO, FL 33594 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 1996-04-22 | 2931 SR 60 E, VALRICO, FL 33594 | No data |
| CHANGE OF MAILING ADDRESS | 1996-04-22 | 2931 SR 60 E, VALRICO, FL 33594 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1996-04-22 | 2931 SR 60 E, VALRICO, FL 33594 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-01 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-03-09 |
| ANNUAL REPORT | 2021-04-13 |
| ANNUAL REPORT | 2020-02-19 |
| ANNUAL REPORT | 2019-03-12 |
| ANNUAL REPORT | 2018-02-28 |
| ANNUAL REPORT | 2017-03-26 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-02-19 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
