| Entity Name: | PODIATRY HEALTH SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Apr 2019 (6 years ago) |
| Document Number: | L19000111337 |
| FEI/EIN Number | 83-4625336 |
| Address: | 1846 SE PORT SAINT LUCIE BLVD, PORT ST LUCIE, FL, 34952, US |
| Mail Address: | 1846 SE PORT SAINT LUCIE BLVD, PORT ST LUCIE, FL, 34952, US |
| ZIP code: | 34952 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700441342 | 2019-05-09 | 2022-09-19 | 1846 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL, 349525545, US | 1846 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL, 349525545, US | |||||||||||||||||||
|
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| Phone | +1 772-301-1951 |
| Fax | 7729347297 |
Authorized person
| Name | KRISTOPHER P JERRY |
| Role | PODIATRIC SURGEON |
| Phone | 7723011951 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| Is Primary | No |
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JERRY KRISTOPHER | Agent | 1846 SE PORT SAINT LUCIE BLVD, PORT ST LUCIE, FL, 34952 |
| Name | Role | Address |
|---|---|---|
| JERRY DAWN | Manager | 1846 SE PORT SAINT LUCIE BLVD, PORT ST LUCIE, FL, 34952 |
| JERRY KRISTOPHER | Manager | 1846 SE PORT SAINT LUCIE BLVD, PORT ST LUCIE, FL, 34952 |
| BURRILL ANDREW | Manager | 1846 SE PORT SAINT LUCIE BLVD, PORT ST LUCIE, FL, 34952 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-16 | 1846 SE PORT SAINT LUCIE BLVD, PORT ST LUCIE, FL 34952 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-05-07 | 1846 SE PORT SAINT LUCIE BLVD, PORT ST LUCIE, FL 34952 | No data |
| CHANGE OF MAILING ADDRESS | 2019-05-07 | 1846 SE PORT SAINT LUCIE BLVD, PORT ST LUCIE, FL 34952 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-17 |
| ANNUAL REPORT | 2023-03-10 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-02-15 |
| ANNUAL REPORT | 2020-03-16 |
| Florida Limited Liability | 2019-04-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
