| Entity Name: | STEVE W. SMITH, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 23 Feb 2011 (14 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 23 Feb 2011 (14 years ago) |
| Document Number: | P11000018812 |
| FEI/EIN Number | 300642211 |
| Address: | 102 SOUTHERN OAKS DRIVE, PLANT CITY, FL, 33563 |
| Mail Address: | 102 SOUTHERN OAKS DRIVE, PLANT CITY, FL, 33563 |
| ZIP code: | 33563 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477851053 | 2011-03-07 | 2011-03-07 | 102 SOUTHERN OAKS DR, PLANT CITY, FL, 335631446, US | 102 SOUTHERN OAKS DR, PLANT CITY, FL, 335631446, US | |||||||||||||||||||||||||
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| Phone | +1 813-750-1441 |
| Fax | 8137576175 |
Authorized person
| Name | DR. STEVE WAYNE SMITH |
| Role | PHYSICIAN/ OWNER |
| Phone | 8137501441 |
Taxonomy
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| License Number | 59079 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 05821400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SMITH STEVE W | Agent | 102 SOUTHERN OAKS DRIVE, PLANT CITY, FL, 33563 |
| Name | Role | Address |
|---|---|---|
| SMITH STEVE W | President | 102 SOUTHERN OAKS DRIVE, PLANT CITY, FL, 33563 |
| Name | Role | Address |
|---|---|---|
| SMITH STEVE W | Director | 102 SOUTHERN OAKS DRIVE, PLANT CITY, FL, 33563 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2011-02-23 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS L10000082683. CONVERSION NUMBER 100000111601 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-22 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-05-15 |
| ANNUAL REPORT | 2019-04-09 |
| ANNUAL REPORT | 2018-03-29 |
| ANNUAL REPORT | 2017-03-20 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
