| Entity Name: | DUNDEE PODIATRY AND THERAPY SERVICES PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 02 Apr 2002 (23 years ago) |
| Last Event: | AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 11 Jan 2016 (9 years ago) |
| Document Number: | P02000035510 |
| FEI/EIN Number | 030418951 |
| Address: | 106 CENTER STREET, DUNDEE, FL, 33838 |
| Mail Address: | 220 LAKE LINK RD, WINTER HAVEN, FL, 33884, US |
| ZIP code: | 33838 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225131626 | 2006-09-07 | 2022-01-19 | 220 LAKE LINK RD, WINTER HAVEN, FL, 338841003, US | 106 CENTER ST, DUNDEE, FL, 338384374, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 863-439-4000 |
| Fax | 8634392257 |
Authorized person
| Name | DR. ANN B HOLLAND |
| Role | OWNER/PHYSICIAN |
| Phone | 8634394000 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| License Number | PO2449 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PALMETTO GBA |
| Number | 4475990001 |
| State | FL |
| Issuer | MEDICAID |
| Number | 340224000 |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | 480033826 |
| State | FL |
| Name | Role |
|---|---|
| SPIEGEL & UTRERA, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| HOLLAND ANN BERNICE | President | 220 LAKE LINK RD, WINTER HAVEN, FL, 33884 |
| Name | Role | Address |
|---|---|---|
| HOLLAND ANN BERNICE | Secretary | 220 LAKE LINK RD, WINTER HAVEN, FL, 33884 |
| Name | Role | Address |
|---|---|---|
| HOLLAND ANN BERNICE | Treasurer | 220 LAKE LINK RD, WINTER HAVEN, FL, 33884 |
| Name | Role | Address |
|---|---|---|
| HOLLAND ANN BERNICE | Director | 220 LAKE LINK RD, WINTER HAVEN, FL, 33884 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000125089 | DUNDEE PODIATRY AND THERAPY SERVICES | EXPIRED | 2015-12-11 | 2020-12-31 | No data | ATT: ANN B HOLLAND, 106 CENTER STREET, DUNDEE, FL, 33838 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-08 | 220 LAKE LINK RD, WINTER HAVEN, FL 33884 | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-19 | 106 CENTER STREET, DUNDEE, FL 33838 | No data |
| AMENDMENT AND NAME CHANGE | 2016-01-11 | DUNDEE PODIATRY AND THERAPY SERVICES PA | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-01-11 | 106 CENTER STREET, DUNDEE, FL 33838 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-04-15 |
| ANNUAL REPORT | 2022-03-01 |
| ANNUAL REPORT | 2021-03-08 |
| ANNUAL REPORT | 2020-05-29 |
| ANNUAL REPORT | 2019-04-05 |
| ANNUAL REPORT | 2018-02-17 |
| ANNUAL REPORT | 2017-03-19 |
| ANNUAL REPORT | 2016-03-29 |
| Amendment and Name Change | 2016-01-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
