| Entity Name: | SUNSHINE PODIATRY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 06 May 2020 (5 years ago) |
| Document Number: | L20000122207 |
| FEI/EIN Number | 85-1096274 |
| Address: | 6910 NEOPOLITAN CT, APOLLO BEACH, FL 33572 |
| Mail Address: | 6910 NEOPOLITAN CT, APOLLO BEACH, FL 33572 |
| ZIP code: | 33572 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891318879 | 2020-05-25 | 2022-08-09 | 6910 NEOPOLITAN CT, APOLLO BEACH, FL, 335721604, US | 11918 BALM RIVERVIEW RD, RIVERVIEW, FL, 335696601, US | |||||||||||||||||||||||
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| Phone | +1 510-206-7935 |
| Fax | 8136586238 |
| Phone | +1 813-522-6522 |
Authorized person
| Name | HUY NGUYEN |
| Role | OWNER |
| Phone | 5102067935 |
Taxonomy
| Taxonomy Code | 261QP1100X - Podiatric Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 106709700 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUNSHINE PODIATRY LLC 401(K) PLAN | 2023 | 851096274 | 2024-05-03 | SUNSHINE PODIATRY LLC | 5 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-03 |
| Name of individual signing | QIAN LIU |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621391 |
| Sponsor’s telephone number | 8135226522 |
| Plan sponsor’s address | 6910 NEOPOLITAN CT, APOLLO BEACH, FL, 33572 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-27 |
| Name of individual signing | CHRISTINE RIMER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| NGUYEN, HUY | Agent | 11918 Balm Riverview Road, RIVERVIEW, FL 33569 |
| Name | Role | Address |
|---|---|---|
| NGUYEN, HUY | Manager | 6910 NEOPOLITAN CT, APOLLO BEACH, FL 33572 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-05-02 | 11918 Balm Riverview Road, RIVERVIEW, FL 33569 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-05-02 |
| ANNUAL REPORT | 2022-05-02 |
| ANNUAL REPORT | 2021-04-30 |
| Florida Limited Liability | 2020-05-06 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
