| Entity Name: | TOWNCARE DENTAL OF WINTER PARK, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 11 May 2011 (14 years ago) |
| Date of dissolution: | 25 Jan 2023 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 25 Jan 2023 (2 years ago) |
| Document Number: | P11000045607 |
| FEI/EIN Number | 45-2350525 |
| Mail Address: | 6240 Lake Osprey Dr., Sarasota, FL 34240 |
| Address: | 1713 WEST FAIRBANKS AVENUE, Winter Park, FL 32789 |
| ZIP code: | 32789 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295028223 | 2011-05-24 | 2015-10-13 | 13195 SW 134TH ST FL 2, MIAMI, FL, 331864461, US | 1713 W FAIRBANKS AVE, WINTER PARK, FL, 327894605, US | |||||||||||||||||||||||||||
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| Phone | +1 305-274-2499 |
| Phone | +1 407-629-1804 |
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 | 1223P0300X - Periodontist |
| Is Primary | No |
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| ALLEN, RUSSELL | Agent | 6240 Lake Osprey Dr., Sarasota, FL 34240 |
| Name | Role | Address |
|---|---|---|
| GALLO, DONALD | Director | 6240 Lake Osprey Dr., Sarasota, FL 34240 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000023854 | DENTAL SPECIALTY CENTER OF WINTER PARK | EXPIRED | 2012-03-08 | 2017-12-31 | No data | 13195 SW 134 STREET, 2ND FLOOR, MIAMI, FL, 33143 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-01-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-05 | 1713 WEST FAIRBANKS AVENUE, Winter Park, FL 32789 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-04-05 | ALLEN, RUSSELL | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-23 | 1713 WEST FAIRBANKS AVENUE, Winter Park, FL 32789 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-23 | 6240 Lake Osprey Dr., Sarasota, FL 34240 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-01-25 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-19 |
| ANNUAL REPORT | 2018-04-16 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-03-30 |
| ANNUAL REPORT | 2015-03-13 |
| ANNUAL REPORT | 2014-04-22 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
