| Entity Name: | CHRISTOPHER ANTHONY SMITH, MD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Mar 2014 (11 years ago) |
| Document Number: | L14000047658 |
| FEI/EIN Number | 46-5169636 |
| Address: | 8297 Champions Gate Blvd,, Unit 5019, ChampionsGate, FL, 33896, US |
| Mail Address: | 8297 Champions Gate Blvd,, Unit 5019, ChampionsGate, FL, 33896, US |
| ZIP code: | 33896 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114338340 | 2014-05-09 | 2021-10-20 | 14837 ELLINGSWORTH LN, WINTER GARDEN, FL, 347875673, US | 616 E ALTAMONTE DR STE 204, ALTAMONTE SPRINGS, FL, 327014810, US | |||||||||||||||||||||
|
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| Phone | +1 347-257-7788 |
| Phone | +1 727-459-3235 |
Authorized person
| Name | DR. CHRISTOPHER A SMITH |
| Role | CEO |
| Phone | 3472577788 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009152500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SMITH CHRISTOPHER A | Agent | 8297 Champions Gate Blvd,, ChampionsGate, FL, 33896 |
| Name | Role | Address |
|---|---|---|
| SMITH CHRISTOPHER A | Chief Executive Officer | 8297 Champions Gate Blvd,, ChampionsGate, FL, 33896 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-27 | 8297 Champions Gate Blvd,, Unit 5019, ChampionsGate, FL 33896 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-23 | 8297 Champions Gate Blvd,, Unit 5019, ChampionsGate, FL 33896 | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-23 | 8297 Champions Gate Blvd,, Unit 5019, ChampionsGate, FL 33896 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-28 |
| ANNUAL REPORT | 2023-04-16 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-06-05 |
| ANNUAL REPORT | 2019-05-18 |
| ANNUAL REPORT | 2018-05-01 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
