| Entity Name: | KATZ ORTHOPAEDIC INSTITUTE, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Jun 2009 (16 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 30 Oct 2016 (8 years ago) |
| Document Number: | L09000052603 |
| FEI/EIN Number | 270311170 |
| Address: | 14153 YOSEMITE DRIVE, SUITE 103, HUDSON, FL, 34667 |
| Mail Address: | 14153 YOSEMITE DRIVE, SUITE 103, HUDSON, FL, 34667, US |
| ZIP code: | 34667 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447480793 | 2009-07-21 | 2009-07-21 | PO BOX 919295, ORLANDO, FL, 328919295, US | 14153 YOSEMITE DR, SUITE 103, HUDSON, FL, 346678060, US | |||||||||||||||||||||||||||
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| Phone | +1 727-869-2663 |
Authorized person
| Name | DR. RICHARD J KATZ |
| Role | MEMBER |
| Phone | 7278692663 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| License Number | ME0064682 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 373528100 |
| State | FL |
| Issuer | INDIVIDUAL NPI |
| Number | 1104854058 |
| Name | Role | Address |
|---|---|---|
| Johannes Wijnmaalen Dr. | Agent | 14153 YOSEMITE DRIVE, HUDSON, FL, 34667 |
| Name | Role | Address |
|---|---|---|
| Wijnmaalen Johannes Dr. | Manager | 2040 Short Avenue, Odessa, FL, 33556 |
| Farhan Siddiqi Manager | Manager | 2040 Short Avenue, Odessa, FL, 33556 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-08-07 | Johannes, Wijnmaalen, Dr. | No data |
| REINSTATEMENT | 2016-10-30 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2016-10-30 | 14153 YOSEMITE DRIVE, SUITE 103, HUDSON, FL 34667 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-10-30 | 14153 YOSEMITE DRIVE, SUITE 103, HUDSON, FL 34667 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-06 | 14153 YOSEMITE DRIVE, SUITE 103, HUDSON, FL 34667 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-08-07 |
| AMENDED ANNUAL REPORT | 2024-07-19 |
| ANNUAL REPORT | 2024-04-02 |
| ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2022-03-04 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-02-22 |
| ANNUAL REPORT | 2017-04-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
