| Entity Name: | VALERIE ANN SMITH, D.P.M., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 02 Mar 2001 (24 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P01000022421 |
| FEI/EIN Number | 593705539 |
| Address: | 1000 BELCHER ROAD SOUTH, SUITE 4, LARGO, FL, 33771, US |
| Mail Address: | 1000 BELCHER ROAD SOUTH, SUITE 4, LARGO, FL, 33771, US |
| ZIP code: | 33771 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588842090 | 2008-02-06 | 2008-06-19 | 1000 BELCHER RD S, SUITE 4, LARGO, FL, 337713321, US | 1000 BELCHER RD S, SUITE 4, LARGO, FL, 337713321, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-530-7585 |
| Fax | 7275361831 |
Authorized person
| Name | DR. VALERIE ANN SMITH |
| Role | PRESIDENT |
| Phone | 7275367585 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | PO2810 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAIL ROAD MEDICARE |
| Number | 480031569 |
| State | FL |
| Issuer | MEDICARE ID |
| Number | 65639 |
| State | FL |
| Issuer | MEDICAID |
| Number | 340209600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SMITH VALERIE A | Agent | 1000 BELCHER ROAD SOUTH, LARGO, FL, 33771 |
| Name | Role | Address |
|---|---|---|
| SMITH VALERIE A | Director | 1000 BELCHER RD S #4, LARGO, FL, 33771 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-15 | 1000 BELCHER ROAD SOUTH, SUITE 4, LARGO, FL 33771 | No data |
| CHANGE OF MAILING ADDRESS | 2009-04-15 | 1000 BELCHER ROAD SOUTH, SUITE 4, LARGO, FL 33771 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-04-05 |
| ANNUAL REPORT | 2017-03-16 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-04-23 |
| ANNUAL REPORT | 2014-03-05 |
| ANNUAL REPORT | 2013-03-31 |
| ANNUAL REPORT | 2012-01-05 |
| ANNUAL REPORT | 2011-05-09 |
| ANNUAL REPORT | 2010-01-08 |
| ANNUAL REPORT | 2009-04-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
