| Entity Name: | ABBUBACCA PARKINSON, DPM, PA. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Aug 2002 (22 years ago) |
| Document Number: | P02000087279 |
| FEI/EIN Number | 030475065 |
| Address: | 6 NW 35 AVE, FT. MYERS, FL, 33993, US |
| Mail Address: | P.O. Box 1330, ESTERO, FL, 33928, US |
| ZIP code: | 33993 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376986224 | 2013-04-10 | 2020-09-22 | PO BOX 1330, ESTERO, FL, 339291330, US | 6 NW 35TH AVE, CAPE CORAL, FL, 339936932, US | |||||||||||||||||||||||||
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| Phone | +1 239-273-8624 |
| Fax | 2394374237 |
Authorized person
| Name | DR. ABBUBACCA PARKINSON |
| Role | OWNER |
| Phone | 2392738624 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| License Number | PO2944 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 340205300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PARKINSON ABBUBACCA D | Agent | 17265 Hadlow Place, Fort Myers, FL, 33967 |
| Name | Role | Address |
|---|---|---|
| Parkinson abbubacca D | Director | 17265 Hadlow Place, Fort Myers, FL, 33967 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-10-13 | 6 NW 35 AVE, FT. MYERS, FL 33993 | No data |
| CHANGE OF MAILING ADDRESS | 2019-02-08 | 6 NW 35 AVE, FT. MYERS, FL 33993 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-02-08 | 17265 Hadlow Place, Fort Myers, FL 33967 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-07 |
| ANNUAL REPORT | 2023-03-24 |
| ANNUAL REPORT | 2022-04-02 |
| ANNUAL REPORT | 2021-03-10 |
| ANNUAL REPORT | 2020-02-25 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-03-25 |
| ANNUAL REPORT | 2017-02-11 |
| ANNUAL REPORT | 2016-03-27 |
| ANNUAL REPORT | 2015-03-15 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
