| Entity Name: | NATURE COAST FOOT AND ANKLE CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Jul 2013 (12 years ago) |
| Document Number: | L13000094079 |
| FEI/EIN Number | 46-3102442 |
| Address: | 6254 W Corporate Oaks Dr, CRYSTAL RIVER, FL, 34429, US |
| Mail Address: | 6254 W Corporate Oaks Dr, CRYSTAL RIVER, FL, 34429, US |
| ZIP code: | 34429 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396185526 | 2013-07-02 | 2014-02-13 | PO BOX 2319, CRYSTAL RIVER, FL, 344232319, US | 6254 W CORPORATE OAKS DR, CRYSTAL RIVER, FL, 344298723, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 352-228-4975 |
| Fax | 3522284977 |
Authorized person
| Name | KENNETH P PRITCHYK |
| Role | OWNER |
| Phone | 3525635488 |
Taxonomy
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA BLUE |
| Number | 004KU |
| State | FL |
| Issuer | DMEPOS |
| Number | 6980350001 |
| State | FL |
| Issuer | MEDICAID |
| Number | 009044800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MCHUGH MATTHEW J | Agent | 216 SOUTH PINE AVENUE, INVERNESS, FL, 34452 |
| Name | Role | Address |
|---|---|---|
| PRITCHYK KENNETH P | Managing Member | 6254 W Corporate Oaks Dr, CRYSTAL RIVER, FL, 34429 |
| Name | Role | Address |
|---|---|---|
| PRITCHYK KENNETH P | Manager | 6254 W Corporate Oaks Dr, CRYSTAL RIVER, FL, 34429 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2014-03-24 | 6254 W Corporate Oaks Dr, CRYSTAL RIVER, FL 34429 | No data |
| CHANGE OF MAILING ADDRESS | 2014-03-24 | 6254 W Corporate Oaks Dr, CRYSTAL RIVER, FL 34429 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-07 |
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-03-31 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-02-25 |
| ANNUAL REPORT | 2020-03-16 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-02-22 |
| ANNUAL REPORT | 2016-01-25 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
