| Entity Name: | GORDON FOOT CARE, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 Nov 2004 (20 years ago) |
| Document Number: | P04000156342 |
| FEI/EIN Number | 141917906 |
| Address: | 333 ARTHUR GODFREY ROAD, 218, MIAMI BEACH, FL, 33140 |
| Mail Address: | 333 ARTHUR GODFREY ROAD, 218, MIAMI BEACH, FL, 33140 |
| ZIP code: | 33140 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902992225 | 2006-10-05 | 2008-03-17 | 333 W 41ST ST, SUITE #218, MIAMI BEACH, FL, 331403641, US | 333 W 41ST ST, SUITE #218, MIAMI BEACH, FL, 331403641, US | |||||||||||||||||||||||||
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| Phone | +1 305-532-5630 |
| Fax | 3055322530 |
Authorized person
| Name | DR. ANDREW GORDON |
| Role | OWNER |
| Phone | 3055325630 |
Taxonomy
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| License Number | PO2890 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 340493500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Gordon Andrew | Agent | 4101 PINE TREE DRIVE, MIAMI BEACH, FL, 33140 |
| Name | Role | Address |
|---|---|---|
| GORDON ANDREW | Director | 4101 PINE TREE DRIVE #310, MIAMI BEACH, FL, 33140 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-01-26 | Gordon, Andrew | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-01-29 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-01-15 |
| ANNUAL REPORT | 2015-02-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
