| Entity Name: | GO SMILE GROUP, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Feb 2020 (5 years ago) |
| Document Number: | L20000047400 |
| FEI/EIN Number | 84-4542777 |
| Address: | 5745 PARK BLVD N, PINELLAS PARK, FL, 33781, US |
| Mail Address: | 5745 PARK BLVD N, PINELLAS PARK, FL, 33781, US |
| ZIP code: | 33781 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528704988 | 2022-05-09 | 2022-08-03 | 5745 PARK BLVD N, PINELLAS PARK, FL, 337813332, US | 5745 PARK BLVD N, PINELLAS PARK, FL, 337813332, US | |||||||||||||||||||||||
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| Phone | +1 727-698-6684 |
Authorized person
| Name | DOROTHY LYNNE CATALDO |
| Role | PEDIATRIC DENTIST/ CO-OWNER |
| Phone | 7276986684 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| Is Primary | Yes |
| Taxonomy Code | 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1659533883 |
| State | IL |
| Name | Role | Address |
|---|---|---|
| GULOY ROBERTZON | Agent | 5745 PARK BLVD N, PINELLAS PARK, FL, 33781 |
| Name | Role | Address |
|---|---|---|
| GULOY ROBERTZON | Manager | 5745 PARK BLVD N, PINELLAS PARK, FL, 33781 |
| CATALDO DOROTHY L | Manager | 5745 PARK BLVD N, PINELLAS PARK, FL, 33781 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-06 | 5745 PARK BLVD N, PINELLAS PARK, FL 33781 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-06 | 5745 PARK BLVD N, PINELLAS PARK, FL 33781 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-06 | 5745 PARK BLVD N, PINELLAS PARK, FL 33781 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-02-02 |
| Florida Limited Liability | 2020-02-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
