| Entity Name: | PALM BEACH PODIATRIC CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 Apr 2004 (21 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 17 Oct 2014 (10 years ago) |
| Document Number: | P04000067131 |
| FEI/EIN Number | 201048255 |
| Address: | 3347 SOUTH STATE ROAD 7, 200, WELLINGTON, FL, 33449, US |
| Mail Address: | 3347 SOUTH STATE ROAD 7, 200, WELLINGTON, FL, 33449, US |
| ZIP code: | 33449 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821284316 | 2007-09-19 | 2009-04-07 | 10115 W FOREST HILL BLVD, SUITE 302, WELLINGTON, FL, 334143105, US | 10115 W FOREST HILL BLVD, SUITE 302, WELLINGTON, FL, 334143105, US | |||||||||||||||||||||||||
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| Phone | +1 561-641-7884 |
| Fax | 5616410440 |
Authorized person
| Name | DR. JEFFREY CARL LERNER |
| Role | DOCTOR |
| Phone | 5616417884 |
Taxonomy
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| License Number | PL1852 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | DG1880 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LERNER JEFFREY DR. | Agent | 3347 SOUTH STATE ROAD 7, WELLINGTON, FL, 33449 |
| Name | Role | Address |
|---|---|---|
| LERNER JEFFREY | DPM | 3347 SOUTH STATE ROAD 7, WELLINGTON, FL, 33449 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-03-16 | 3347 SOUTH STATE ROAD 7, 200, B, WELLINGTON, FL 33449 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-16 | 3347 SOUTH STATE ROAD 7, 200, B, WELLINGTON, FL 33449 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-16 | 3347 SOUTH STATE ROAD 7, 200, B, WELLINGTON, FL 33449 | No data |
| REINSTATEMENT | 2014-10-17 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CANCEL ADM DISS/REV | 2007-03-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-25 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-03-16 |
| ANNUAL REPORT | 2020-02-16 |
| ANNUAL REPORT | 2019-04-10 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-29 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-04-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
