| Entity Name: | FT. MYERS DENTAL SERVICES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 30 Mar 1990 (35 years ago) |
| Last Event: | AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 22 May 2002 (23 years ago) |
| Document Number: | L61134 |
| FEI/EIN Number | 65-0195566 |
| Mail Address: | 6240 Lake Osprey Dr., Sarasota, FL 34240 |
| Address: | 6150 DIAMOND CENTER CT, BUILDING 300, SUITE 2, FT. MYERS, FL 33912 |
| ZIP code: | 33912 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528171071 | 2006-08-17 | 2014-08-21 | 13195 SW 134 ST, 2ND FLOOR, MIAMI, FL, 33186, US | 6150 DIAMOND CENTER CT, BLDG 300, SUITE 2, FT MYERS, FL, 33912, US | |||||||||||||||||||
|
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| Phone | +1 305-274-2499 |
| Phone | +1 239-433-4746 |
Authorized person
| Name | STEPHANIE GOMEZ |
| Role | PROVIDER RELATIONS |
| Phone | 3052742499 |
Taxonomy
| Taxonomy Code | 1223E0200X - Endodontist |
| Is Primary | No |
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Gallo, Donald | Director | 13195 SW 134TH STREET 2ND FLOOR, MIAMI, FL 33186 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000012198 | TOWNCARE DENTAL OF FT. MYERS | EXPIRED | 2018-01-22 | 2023-12-31 | No data | 6240 LAKE OSPREY DRIVE, SARASOTA, FL, 34240 |
| G10000045436 | MAIN STREET CHILDREN'S DENTISTRY OF FT. MYERS | EXPIRED | 2010-05-24 | 2015-12-31 | No data | 6150 DIAMOND CENTER CT., 300 #2, FT. MYERS, FL, 33912 |
| G10000045437 | MAIN STREET CHILDREN'S DENTISTRY OF CAPE CORAL | EXPIRED | 2010-05-24 | 2015-12-31 | No data | 6150 DIAMOND CENTER CT., 300 # 2, FT. MYERS, FL, 33912 |
| G10000038308 | TOWNCARE DENTAL OF FT. MYERS | EXPIRED | 2010-04-30 | 2015-12-31 | No data | 6150 DIAMOND CENTER CT., BLDG. 300, SUITE 2, FT. MYERS, FL, 33912 |
| G09000152131 | DENTAL SPECIALTY CENTER OF FT MYERS | EXPIRED | 2009-09-02 | 2014-12-31 | No data | 13195 SW 134 ST, 2ND FLOOR, MIAMI, FL, 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-05-01 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-05-01 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-23 | 6150 DIAMOND CENTER CT, BUILDING 300, SUITE 2, FT. MYERS, FL 33912 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-04-26 | 6150 DIAMOND CENTER CT, BUILDING 300, SUITE 2, FT. MYERS, FL 33912 | No data |
| AMENDMENT AND NAME CHANGE | 2002-05-22 | FT. MYERS DENTAL SERVICES, P.A. | No data |
| Name | Date |
|---|---|
| Reg. Agent Change | 2024-05-01 |
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-06-25 |
| ANNUAL REPORT | 2019-04-16 |
| ANNUAL REPORT | 2018-04-16 |
| ANNUAL REPORT | 2017-03-31 |
| ANNUAL REPORT | 2016-03-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
