| Entity Name: | ST. ANTHONY HEALTH CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Oct 2011 (13 years ago) |
| Document Number: | L11000121985 |
| FEI/EIN Number | 454284635 |
| Address: | 2103 S. MCCALL RD., ENGLEWOOD, FL, 34224, US |
| Mail Address: | 2103 S. MCCALL RD., ENGLEWOOD, FL, 34224, US |
| ZIP code: | 34224 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1194091454 | 2012-03-30 | 2023-03-01 | 2103 S MCCALL RD, ENGLEWOOD, FL, 342244541, US | 2103 S MCCALL RD, ENGLEWOOD, FL, 342244541, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 941-441-9007 |
| Fax | 9412493119 |
Authorized person
| Name | MRS. ASHLEY DALETTO |
| Role | OFFICE ADMINISTRATOR |
| Phone | 9414419007 |
Taxonomy
| Taxonomy Code | 171100000X - Acupuncturist |
| Is Primary | No |
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME100763 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 204C00000X - Sports Medicine (Neuromusculoskeletal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 207ZN0500X - Neuropathology Physician |
| Is Primary | No |
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | No |
| Taxonomy Code | 2083A0300X - Addiction Medicine (Preventive Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 2083P0500X - Preventive Medicine/Occupational Environmental Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208U00000X - Clinical Pharmacology Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 225700000X - Massage Therapist |
| Is Primary | No |
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0243461 |
| State | FL |
| Issuer | MEDICAID |
| Number | I22622 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Little Lew AMD | Agent | 2103 S. MCCALL RD., ENGLEWOOD, FL, 34224 |
| Name | Role | Address |
|---|---|---|
| LITTLE LEW AMD | Manager | 2103 S. MCCALL RD., ENGLEWOOD, FL, 34224 |
| Name | Role | Address |
|---|---|---|
| Little Lew | Officer | 2103 S. MCCALL RD., ENGLEWOOD, FL, 34224 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2019-04-03 | Little, Lew Anthony, MD | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-03-13 | 2103 S. MCCALL RD., ENGLEWOOD, FL 34224 | No data |
| CHANGE OF MAILING ADDRESS | 2012-03-13 | 2103 S. MCCALL RD., ENGLEWOOD, FL 34224 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-03-13 | 2103 S. MCCALL RD., ENGLEWOOD, FL 34224 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-07-11 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-02-02 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-01-03 |
| ANNUAL REPORT | 2017-02-01 |
| ANNUAL REPORT | 2016-03-21 |
| ANNUAL REPORT | 2015-03-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
