| Entity Name: | GEORGE E HITZEL. D.D.S.,P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 17 Nov 2008 (16 years ago) |
| Document Number: | P08000102515 |
| FEI/EIN Number | 82-5210299 |
| Address: | 2385 Northwest Executive Center Dr, Suite 100, Boca Raton, FL, 33431, US |
| Mail Address: | 2385 Northwest Executive Center Dr, Suite 100, Boca Raton, FL, 33431, US |
| ZIP code: | 33431 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881849578 | 2008-11-21 | 2008-11-21 | 1330 S BELCHER RD, CLEARWATER, FL, 337643713, US | 1330 S BELCHER RD, CLEARWATER, FL, 337643713, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 727-535-3233 |
| Fax | 7275351185 |
Authorized person
| Name | GEORGE E HITZEL |
| Role | OWNER |
| Phone | 7275353233 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | DN-11998 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI - DR. HITZEL |
| Number | 1063545242 |
| State | FL |
| Issuer | NPI - DR. MILNE |
| Number | 1871719807 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| General Dental Office | Agent | 1330 SOUTH BELCHER ROAD, CLEARWATER, FL, 33764 |
| Name | Role | Address |
|---|---|---|
| Guardian Dentistry Partners | Officer | 5803 Northwest 151st Street, Miami Lakes,, Miami Lakes, FL, 33014 |
| Kay Holly VP Oper | Officer | 1330 SOUTH BELCHER ROAD, CLEARWATER, FL, 33764 |
| Name | Role | Address |
|---|---|---|
| Hitzel George E | Owne | 7219 3RD AVE SOUTH, ST PETERSBURG, FL, 33707 |
| Name | Role | Address |
|---|---|---|
| Kay Holly VP Oper | Vice President | 1330 SOUTH BELCHER ROAD, CLEARWATER, FL, 33764 |
| Hitzel Alison | Vice President | 1330 SOUTH BELCHER ROAD, CLEARWATER, FL, 33764 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000063297 | GEORGE E. HITZEL DDS PA, DBA CHAMPAGNE DENTAL CORP. | ACTIVE | 2019-05-31 | 2029-12-31 | No data | 1330 SOUTH BELCHER RD, CLEARWATER, FL, 33764 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-15 | 2385 Northwest Executive Center Dr, Suite 100, Boca Raton, FL 33431 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-15 | 2385 Northwest Executive Center Dr, Suite 100, Boca Raton, FL 33431 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-04-10 | General Dental Office | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-15 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-25 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-29 |
| ANNUAL REPORT | 2019-04-10 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-01-18 |
| ANNUAL REPORT | 2015-01-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
