| Entity Name: | EXCEL CARE ORTHOPEDICS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 25 Oct 2017 (7 years ago) |
| Document Number: | L17000221059 |
| FEI/EIN Number | 82-3203199 |
| Mail Address: | 3801 PARK STREET NORTH, SUITE 3, ST. PETERSBURG, FL 33709 |
| Address: | 300 Riverside Drive East, Suite 1300, Bradenton, FL 34208 |
| ZIP code: | 34208 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972017275 | 2017-11-22 | 2017-11-22 | 300 RIVERSIDE DR E STE 1300, BRADENTON, FL, 342081022, US | 300 RIVERSIDE DR E STE 1300, BRADENTON, FL, 342081022, US | |||||||||||||||||||||||||||
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| Phone | +1 941-870-2120 |
| Fax | 9413253595 |
| Fax | 9413283595 |
Authorized person
| Name | DR. RAFAT S NASHED |
| Role | PRESIDENT/PHYSICIAN |
| Phone | 9418702120 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| License Number | ME109000 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 00421880 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Gregory, Ronald W., II | Agent | GREGORY LAW FIRM, P.L., 3801 PARK STREET NORTH, SUITE 3, ST. PETERSBURG, FL 33709 |
| Name | Role | Address |
|---|---|---|
| NASHED, RAFAT S, M.D. | Manager | 300 Riverside Drive East, Suite 1300, Bradenton, FL 34208 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-16 | 300 Riverside Drive East, Suite 1300, Bradenton, FL 34208 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-04-08 | Gregory, Ronald W., II | No data |
| CHANGE OF MAILING ADDRESS | 2020-03-31 | 300 Riverside Drive East, Suite 1300, Bradenton, FL 34208 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-31 | GREGORY LAW FIRM, P.L., 3801 PARK STREET NORTH, SUITE 3, ST. PETERSBURG, FL 33709 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-03-21 |
| ANNUAL REPORT | 2022-04-14 |
| ANNUAL REPORT | 2021-04-08 |
| ANNUAL REPORT | 2020-03-31 |
| ANNUAL REPORT | 2019-04-11 |
| ANNUAL REPORT | 2018-03-15 |
| Florida Limited Liability | 2017-10-25 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
