| Entity Name: | IHN PODIATRY SERVICES PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
IHN PODIATRY SERVICES PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 29 Jun 2020 (5 years ago) |
| Document Number: | L20000181410 |
| FEI/EIN Number |
85-1975787
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 5304 S FLORIDA AVE STE 406, LAKELAND, FL, 33813-4914, US |
| Mail Address: | 5304 S FLORIDA AVE STE 406, LAKELAND, FL, 33813-4914, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073231353 | 2022-08-22 | 2023-01-27 | 5304 S FLORIDA AVE STE 400F, LAKELAND, FL, 338134914, US | 5304 S FLORIDA AVE STE 400F, LAKELAND, FL, 338134914, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 863-738-6601 |
Authorized person
| Name | MRS. GLORIED EBSWORTH |
| Role | PROVIDER |
| Phone | 3057819667 |
Taxonomy
| Taxonomy Code | 163WW0000X - Wound Care Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 213E00000X - Podiatrist |
| Is Primary | Yes |
| Taxonomy Code | 213EP1101X - Primary Podiatric Medicine Podiatrist |
| Is Primary | No |
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 116891200 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| IHN PODIATRY SERVICES 401(K) PLAN | 2023 | 851975787 | 2024-05-17 | IHN PODIATRY SERVICES PLLC | 0 | |||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||
| 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 | 2024-05-17 |
| Name of individual signing | QIAN LIU |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| EBSWORTH JOHN P | Manager | 5304 S FLORIDA AVE STE 406, LAKELAND, FL, 338134914 |
| EBSWORTH GLORIED M | Agent | 5304 S FLORIDA AVE STE 406, LAKELAND, FL, 338134914 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000098990 | BEDSIDE WOUND CARE | ACTIVE | 2022-08-22 | 2027-12-31 | - | 5304 S FLORIDA AVE STE 406, LAKELAND, FL, 33813-4914 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-22 | 5304 S FLORIDA AVE STE 406, LAKELAND, FL 33813-4914 | - |
| CHANGE OF MAILING ADDRESS | 2025-01-22 | 5304 S FLORIDA AVE STE 406, LAKELAND, FL 33813-4914 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2025-01-22 | 5304 S FLORIDA AVE STE 406, LAKELAND, FL 33813-4914 | - |
| CHANGE OF MAILING ADDRESS | 2024-11-07 | 5304 S FLORIDA AVE STE 400F, LAKELAND, FL 33813-4914 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-31 | 5304 S FLORIDA AVE STE 400F, LAKELAND, FL 33813-4914 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2022-08-29 | 5304 S FLORIDA AVE STE 400F, LAKELAND, FL 33813-4914 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-22 |
| AMENDED ANNUAL REPORT | 2024-11-07 |
| ANNUAL REPORT | 2024-01-16 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-02-03 |
| Florida Limited Liability | 2020-06-29 |
Date of last update: 01 May 2025
Sources: Florida Department of State
