| Entity Name: | GENTLE FOOT CARE CLINIC, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 Jan 2004 (21 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 27 Dec 2021 (3 years ago) |
| Document Number: | P04000013001 |
| FEI/EIN Number | 200626407 |
| Address: | 38192 MEDICAL CENTER AVE, ZEPHYRHILLS, FL, 33540 |
| Mail Address: | 38192 MEDICAL CENTER AVE, ZEPHYRHILLS, FL, 33540 |
| ZIP code: | 33540 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750097176 | 2023-01-30 | 2023-01-30 | 601 LITHIA PINECREST RD, BRANDON, FL, 335116114, US | 601 LITHIA PINECREST RD, BRANDON, FL, 335116114, US | |||||||||||||||||||||
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| Phone | +1 813-782-3233 |
| Fax | 8135025904 |
Authorized person
| Name | JAIRO B CRUZ |
| Role | MEDICAL DIRECTOR |
| Phone | 8137823233 |
Taxonomy
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | DME |
| Number | 5157370001 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Cruz Jairo Jr. | Agent | 38192 MEDICAL CENTER AVE, ZEPHYRHILLS, FL, 33540 |
| Name | Role | Address |
|---|---|---|
| Cruz Jairo Jr. | Director | 38192 MEDICAL CENTER AVE, ZEPHYRHILLS, FL, 33540 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G04034700024 | GENTLE FOOT CARE CLINIC | EXPIRED | 2004-02-03 | 2024-12-31 | No data | 38192 MEDICAL CENTER AVE, ZEPHYRHILLS, FL, 33540-1380 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 2021-12-27 | GENTLE FOOT CARE CLINIC, PA | No data |
| REGISTERED AGENT NAME CHANGED | 2020-04-13 | Cruz, Jairo, Jr. | No data |
| CHANGE OF MAILING ADDRESS | 2011-02-23 | 38192 MEDICAL CENTER AVE, ZEPHYRHILLS, FL 33540 | No data |
| REINSTATEMENT | 2010-09-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-03-02 |
| Name Change | 2021-12-27 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-04-13 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-03-23 |
| ANNUAL REPORT | 2016-04-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
