| Entity Name: | PETER B WILLIAMS DPM CWS PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 May 2011 (14 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P11000045427 |
| FEI/EIN Number | 510505800 |
| Address: | 10148 US HWY 19, PORT RICHEY, FL, 34668 |
| Mail Address: | PO BOX 1084, PORT RICHEY, FL, 34673 |
| ZIP code: | 34668 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154428357 | 2006-09-20 | 2011-05-25 | PO BOX 1084, PORT RICHEY, FL, 346731084, US | 10148 US HIGHWAY 19, PORT RICHEY, FL, 346683743, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-869-9191 |
| Fax | 7277341808 |
Authorized person
| Name | DR. PETER B WILLIAMS |
| Role | PRESIDENT/OWNER |
| Phone | 7278699191 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| License Number | FLPO0002239 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | EVERCARE (UHC) |
| Number | 27-05819 |
| State | FL |
| Issuer | MEDICAID |
| Number | 058885700 |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | P00116444 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WILLIAMS PETER | Agent | 10148 US HWY 19, PORT RICHEY, FL, 34668 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS PETER | President | 10148 US HWY 19, PORT RICHEY, FL, 34668 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| REINSTATEMENT | 2013-05-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J18000089748 | ACTIVE | 1000000774139 | PASCO | 2018-02-22 | 2038-02-28 | $ 330.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, HOLIDAY SERVICE CENTER, 2127 GRAND BLVD STE 150, HOLIDAY FL346904554 |
| J17000662215 | ACTIVE | 1000000765000 | PASCO | 2017-12-04 | 2037-12-06 | $ 330.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, HOLIDAY SERVICE CENTER, 2127 GRAND BLVD STE 150, HOLIDAY FL346904554 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-04-30 |
| REINSTATEMENT | 2013-05-15 |
| Domestic Profit | 2011-05-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
