| Entity Name: | BROWARD FOOT AND ANKLE SPECIALIST P A |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 23 May 2012 (13 years ago) |
| Document Number: | P12000047858 |
| FEI/EIN Number | 45-5339282 |
| Address: | 2205 BAY DRIVE, POMPANO BEACH, FL 33062 |
| Mail Address: | 2205 BAY DRIVE, POMPANO BEACH, FL 33062 |
| ZIP code: | 33062 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790046290 | 2012-06-01 | 2019-10-03 | 2205 BAY DR, POMPANO BEACH, FL, 330622912, US | 2205 BAY DR, POMPANO BEACH, FL, 330622912, US | |||||||||||||||||||||
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| Phone | +1 917-582-4010 |
| Fax | 7187668606 |
Authorized person
| Name | DR. EFROSINI FOTOPOULOS |
| Role | PRESIDENT |
| Phone | 9175824010 |
Taxonomy
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010144200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FOTOPOULOS, EFROSINI | Agent | 2205 BAY DRIVE, POMPANO BEACH, FL 33062 |
| Name | Role | Address |
|---|---|---|
| FOTOPOULOS, EFROSINI | President | 2205 BAY DRIVE, POMPANO BEACH, FL 33062 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-10 |
| ANNUAL REPORT | 2024-02-10 |
| ANNUAL REPORT | 2023-02-15 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-05-26 |
| ANNUAL REPORT | 2019-02-25 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-02-04 |
| ANNUAL REPORT | 2016-03-18 |
Date of last update: 22 Feb 2025
Sources: Florida Department of State
