| Entity Name: | CENTRAL FLORIDA FOOT CARE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Oct 2002 (22 years ago) |
| Document Number: | P02000108169 |
| FEI/EIN Number | 223878283 |
| Address: | 913 E. North Blvd, LEESBURG, FL, 34748, US |
| Mail Address: | P.O. BOX 491334, LEESBURG, FL, 34749 |
| ZIP code: | 34748 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548378110 | 2006-08-25 | 2008-07-17 | PO BOX 491334, LEESBURG, FL, 347491334, US | 305 CHILDS ST, LEESBURG, FL, 34748, US | |||||||||||||||||||||||||
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| Phone | +1 352-360-1360 |
| Fax | 3523600686 |
Authorized person
| Name | NICHOLAS PRZYSTAWSKI |
| Role | OWNER |
| Phone | 3523601360 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| License Number | PO 2004 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS/BLUE SHIELD |
| Number | 65384 |
| State | FL |
| Name | Role |
|---|---|
| CENTRAL FLORIDA FOOT CARE, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| PRZYSTAWSKI NICHOLAS | Manager | 5320 Treasure View Way, Leesburg, FL, 34748 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-22 | 913 E. North Blvd, Ste. B, LEESBURG, FL 34748 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-22 | 913 E. North Blvd, Ste. B, LEESBURG, FL 34748 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-01-29 | Central Florida Foot Care, P.A. | No data |
| CHANGE OF MAILING ADDRESS | 2003-01-27 | 913 E. North Blvd, Ste. B, LEESBURG, FL 34748 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J17000666000 | LAPSED | 35-2017-CA-000562 | CIRCUIT COURT FOR LAKE COUNTY | 2017-12-03 | 2022-12-14 | $40,673.41 | PNC BANK, NA, C/O BROWN & ASSOCIATES; 232 19TH ST NW, SUITE 7210, ATLANTA, GA 30363 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-02 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-01-19 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-04-22 |
| ANNUAL REPORT | 2017-01-29 |
| ANNUAL REPORT | 2016-01-24 |
| ANNUAL REPORT | 2015-01-13 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
