| Entity Name: | PODIATRY & BAREFOOT WELLNESS CENTERS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Jul 2010 (15 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 11 Jan 2024 (a year ago) |
| Document Number: | L10000077035 |
| FEI/EIN Number | 59-2809274 |
| Address: | 6099 Sabal Hammock Cir, Port Orange, FL, 32128, US |
| Mail Address: | 6099 Sabal Hammock Cir., Port Orange, FL, 32128, US |
| ZIP code: | 32128 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578696878 | 2007-03-14 | 2013-11-19 | 1205 BEACH BLVD, JACKSONVILLE BEACH, FL, 322503405, US | 1205 BEACH BLVD, JACKSONVILLE BEACH, FL, 322503405, US | |||||||||||||||||||||
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| Phone | +1 904-389-0346 |
| Fax | 9042465449 |
Authorized person
| Name | DR. HOWARD J GROSHELL |
| Role | PRESIDENT DIRECTOR |
| Phone | 9043890346 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 390197100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Shultz Eric Dr. | Agent | 6099 Sabal Hammock Cir, Port Orange, FL, 32128 |
| Name | Role | Address |
|---|---|---|
| DPM Eric SDr. | Manager | 6099 Sabal Hammock Cir, Port Orange, FL, 32128 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-01-11 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-11 | 6099 Sabal Hammock Cir, Port Orange, FL 32128 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-11 | 6099 Sabal Hammock Cir, Port Orange, FL 32128 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-11 | 6099 Sabal Hammock Cir, Port Orange, FL 32128 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REINSTATEMENT | 2020-10-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-04-19 | Shultz, Eric, Dr. | No data |
| LC NAME CHANGE | 2013-06-17 | PODIATRY & BAREFOOT WELLNESS CENTERS, LLC | No data |
| MERGER | 2010-09-17 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 100000107961 |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-01-11 |
| ANNUAL REPORT | 2022-03-22 |
| ANNUAL REPORT | 2021-04-28 |
| REINSTATEMENT | 2020-10-07 |
| ANNUAL REPORT | 2019-09-19 |
| ANNUAL REPORT | 2018-03-16 |
| ANNUAL REPORT | 2017-01-17 |
| ANNUAL REPORT | 2016-04-19 |
| ANNUAL REPORT | 2015-04-08 |
| ANNUAL REPORT | 2014-03-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
