| Entity Name: | TOWNCARE DENTAL OF BONITA SPRINGS, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 21 Jan 2009 (16 years ago) |
| Document Number: | P09000006559 |
| FEI/EIN Number | 26-4093890 |
| Mail Address: | 6240 Lake Osprey Dr., Sarasota, FL 34240 |
| Address: | 16565 VANDERBILT DRIVE, BONITA SPRINGS, FL 34134 |
| ZIP code: | 34134 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174948723 | 2014-02-19 | 2014-08-06 | 13195 SW 134 ST, 2ND FLOOR, MIAMI, FL, 33186, US | 16565 VANDERBILT DR, BONITA SPRINGS, FL, 341347552, US | |||||||||||||||||||||||||||
|
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| Phone | +1 305-274-2499 |
| Phone | +1 239-498-6780 |
Authorized person
| Name | STEPHANIE GOMEZ |
| Role | PROVIDER RELATIONS SPECIALIST |
| Phone | 3052742499 |
Taxonomy
| Taxonomy Code | 1223E0200X - Endodontist |
| Is Primary | No |
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| Is Primary | No |
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| Is Primary | No |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Gallo, Donald | Director | 13195 SW 134 STREET, 2ND FLOOR, MIAMI, FL 33186 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000012201 | DENTAL SPECIALTY CENTER OF BONITA SPRINGS | EXPIRED | 2018-01-22 | 2023-12-31 | No data | 6240 LAKE OSPREY DRIVE, SARASOTA, FL, 34240 |
| G10000048482 | MAIN STREET CHILDREN'S DENTISTRY OF BONITA SPRINGS | EXPIRED | 2010-06-04 | 2015-12-31 | No data | 16565 VANDERBILT DRIVE, BONITA SPRINGS, FL, 34134 |
| G09000152132 | DENTAL SPECIALTY CENTER OF BONITA SPRINGS | EXPIRED | 2009-09-02 | 2014-12-31 | No data | 13195 SW 134 ST, 2ND FL, MIAMI, FL, 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-05-03 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-05-03 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-23 | 16565 VANDERBILT DRIVE, BONITA SPRINGS, FL 34134 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-06-25 |
| ANNUAL REPORT | 2019-04-17 |
| ANNUAL REPORT | 2018-04-16 |
| ANNUAL REPORT | 2017-03-31 |
| ANNUAL REPORT | 2016-03-30 |
| ANNUAL REPORT | 2015-03-13 |
Date of last update: 26 Jan 2025
Sources: Florida Department of State
