| Entity Name: | KIDSVILLE PEDIATRICS III, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
KIDSVILLE PEDIATRICS III, 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: | 01 Jul 2004 (21 years ago) |
| Document Number: | P04000099541 |
| FEI/EIN Number |
731711024
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1804 OAKLEY SEAVER DRIVE, SUITE -C, CLERMONT, FL, 34711 |
| Mail Address: | PO BOX 452223, KISSIMMEE, FL, 34745 |
| ZIP code: | 34711 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215901723 | 2006-02-14 | 2022-10-07 | 1804 OAKLEY SEAVER BLVD, SUITE-C, CLERMONT, FL, 347111925, US | 1804 OAKLEY SEAVER BLVD, SUITE-C, CLERMONT, FL, 347111925, US | |||||||||||||||||||||||||||||||
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| Phone | +1 352-242-1021 |
| Fax | 3522421104 |
Authorized person
| Name | MR. VICTOR M. PANTOJA JR. |
| Role | ADMINISTRATOR |
| Phone | 3522421021 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME-0074421 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | FL206A |
| State | FL |
| Issuer | MEDICAID |
| Number | 001599400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GONZALEZ FRANCELIS IDr. | Chief Executive Officer | PO BOX 452223, KISSIMMEE, FL, 34745 |
| PANTOJA VICTOR MJr. | President | PO BOX 452223, KISSIMMEE, FL, 34745 |
| PANTOJA VICTOR MJr. | Agent | 1804 OAKLEY SEAVER DRIVE, CLERMONT, FL, 34741 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000064806 | KIDSVILLE III FAMILY MEDICINE, PA | ACTIVE | 2012-06-28 | 2027-12-31 | - | 1804 OAKLEY SEAVER DR SUITE C, SCENIC OAK CT, CLERMONT, FL, 34711 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2015-02-21 | PANTOJA , VICTOR M, Jr. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2010-03-22 | 1804 OAKLEY SEAVER DRIVE, SUITE -C, CLERMONT, FL 34741 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2005-01-19 | 1804 OAKLEY SEAVER DRIVE, SUITE -C, CLERMONT, FL 34711 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-02-17 |
| ANNUAL REPORT | 2022-02-22 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-02-17 |
| ANNUAL REPORT | 2019-02-09 |
| ANNUAL REPORT | 2018-03-10 |
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-03-04 |
| ANNUAL REPORT | 2015-02-21 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
