| Entity Name: | EMERALD COAST FOOT AND ANKLE CENTER, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 30 Nov 2020 (4 years ago) |
| Document Number: | L20000374257 |
| FEI/EIN Number | 85-4076441 |
| Address: | 4313 Spanish Trail, PENSACOLA, FL 32504 |
| Mail Address: | 4313 Spanish Trail, PENSACOLA, FL 32504 |
| ZIP code: | 32504 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659961084 | 2021-01-20 | 2021-08-16 | 717 RIO VISTA DR, PENSACOLA BEACH, FL, 325612275, US | 8333 N DAVIS HWY STE 6E, PENSACOLA, FL, 325146050, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 850-764-1847 |
Authorized person
| Name | KRISTYN BILLINGS |
| Role | CREDENTIALING |
| Phone | 4126554362 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE LICENSE |
| Number | PO4232 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SPEER, CARL G, JR | Agent | 2400 Connell Drive, PENSACOLA, FL 32503 |
| Name | Role | Address |
|---|---|---|
| SPEER, CARL G, JR | Manager | 717 RIO VISTA DRIVE, PENSACOLA BEACH, FL 32561 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-09-12 | 4313 Spanish Trail, PENSACOLA, FL 32504 | No data |
| CHANGE OF MAILING ADDRESS | 2024-09-12 | 4313 Spanish Trail, PENSACOLA, FL 32504 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-18 | 2400 Connell Drive, PENSACOLA, FL 32503 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-05 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-03-15 |
| Florida Limited Liability | 2020-11-30 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
