| Entity Name: | MELBOURNE PODIATRY ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
MELBOURNE PODIATRY ASSOCIATES, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 01 Jul 1981 (44 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 03 Apr 2018 (7 years ago) |
| Document Number: | 691673 |
| FEI/EIN Number |
592091713
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1515 Dr. Martin Luther King Jr. Blvd, MELBOURNE, FL, 32901, US |
| Mail Address: | 1515 Dr. Martin Luther King Jr. Blvd, MELBOURNE, FL, 32901, US |
| ZIP code: | 32901 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174506877 | 2005-11-28 | 2023-05-12 | 1515 DR MARTIN LUTHER KING JR BLVD, MELBOURNE, FL, 329012946, US | 1515 DR MARTIN LUTHER KING JR BLVD, MELBOURNE, FL, 329012946, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 321-723-3500 |
| Fax | 3217231945 |
Authorized person
| Name | DR. JARED B MOYLES |
| Role | PRESIDENT |
| Phone | 3217233500 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 72224 |
| State | FL |
| Issuer | MEDICAID |
| Number | 041009800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MOYLES JARED B | Director | 1515 Dr. Martin Luther King Jr. Blvd, MELBOURNE, FL, 32901 |
| MOYLES JARED B | President | 1515 Dr. Martin Luther King Jr. Blvd, MELBOURNE, FL, 32901 |
| WILSON THOMAS | Director | 1515 Dr. Martin Luther King Jr. Blvd, MELBOURNE, FL, 32901 |
| WILSON THOMAS | Secretary | 1515 Dr. Martin Luther King Jr. Blvd, MELBOURNE, FL, 32901 |
| WILSON JESSICA | Director | 1515 Dr. Martin Luther King Jr. Blvd, MELBOURNE, FL, 32901 |
| WILSON JESSICA | Vice President | 1515 Dr. Martin Luther King Jr. Blvd, MELBOURNE, FL, 32901 |
| WILSON JESSICA | Treasurer | 1515 Dr. Martin Luther King Jr. Blvd, MELBOURNE, FL, 32901 |
| FRESE GARY BEsq. | Agent | 2200 FRONT STREET, MELBOURNE, FL, 32901 |
| WILSON THOMAS | Vice President | 1515 Dr. Martin Luther King Jr. Blvd, MELBOURNE, FL, 32901 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G05032900284 | MELBOURNE PODIATRY ASSOCIATES | ACTIVE | 2005-02-01 | 2025-12-31 | - | 1515 DR MARTIN LUTHER KING JR BLVD, MELBOURNE, FL, 32901 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-01-17 | 1515 Dr. Martin Luther King Jr. Blvd, MELBOURNE, FL 32901 | - |
| CHANGE OF MAILING ADDRESS | 2020-01-17 | 1515 Dr. Martin Luther King Jr. Blvd, MELBOURNE, FL 32901 | - |
| NAME CHANGE AMENDMENT | 2018-04-03 | MELBOURNE PODIATRY ASSOCIATES, P.A. | - |
| REGISTERED AGENT NAME CHANGED | 2018-01-23 | FRESE, GARY B, Esq. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2010-03-22 | 2200 FRONT STREET, SUITE 301, MELBOURNE, FL 32901 | - |
| CANCEL ADM DISS/REV | 2008-11-12 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-17 |
| AMENDED ANNUAL REPORT | 2024-02-20 |
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-01-20 |
| ANNUAL REPORT | 2021-01-25 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-04-19 |
| Name Change | 2018-04-03 |
| ANNUAL REPORT | 2018-01-23 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7712787201 | 2020-04-28 | 0455 | PPP | 1515 DR MARTIN LUTHER KING JR BLVD, MELBOURNE, FL, 32901 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of last update: 02 May 2025
Sources: Florida Department of State
