| Entity Name: | COLLIER PODIATRY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
COLLIER PODIATRY, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| 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: | 31 May 2002 (23 years ago) |
| Document Number: | P02000060650 |
| FEI/EIN Number |
010733526
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1715 HERITAGE TRAIL, SUITE 204, NAPLES, FL, 34112, US |
| Mail Address: | 1715 HERITAGE TRAIL, SUITE 204, NAPLES, FL, 34112, US |
| ZIP code: | 34112 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164634556 | 2007-05-06 | 2023-03-07 | 1715 HERITAGE TRL, SUITE 204, NAPLES, FL, 341128715, US | 1715 HERITAGE TRL, SUITE 204, NAPLES, FL, 341128715, US | |||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 239-775-0019 |
| Fax | 2397750219 |
Authorized person
| Name | DR. MICHAEL JOHN PETROCELLI |
| Role | PRESIDENT |
| Phone | 2397750019 |
Taxonomy
| Taxonomy Code | 213ES0131X - Foot Surgery Podiatrist |
| License Number | PO-2399 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI PERSONAL NUMBER |
| Number | 1811988165 |
| Issuer | AETNA NUMBER |
| Number | 4574474 |
| State | FL |
| Issuer | STATE LICENSE NUMBER |
| Number | PO-2399 |
| State | FL |
| Issuer | BCBS NUMBER |
| Number | 65356A |
| State | FL |
| Issuer | MEDICAID |
| Number | 340308400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PETROCELLI MICHAEL J | Director | 1715 HERITAGE TRAIL, SUITE 204, NAPLES, FL, 34112 |
| PETROCELLI MICHAEL J | Agent | 1715 HERITAGE TRAIL, SUITE 204, NAPLES, FL, 34112 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2011-01-16 | 1715 HERITAGE TRAIL, SUITE 204, NAPLES, FL 34112 | - |
| CHANGE OF MAILING ADDRESS | 2011-01-16 | 1715 HERITAGE TRAIL, SUITE 204, NAPLES, FL 34112 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2002-09-23 | 1715 HERITAGE TRAIL, SUITE 204, NAPLES, FL 34112 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-21 |
| ANNUAL REPORT | 2024-01-14 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-03-22 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-04-03 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-02-28 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
