| Entity Name: | BERNADETTE SANTOS MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
BERNADETTE SANTOS MD PA is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 04 Oct 2012 (13 years ago) |
| Document Number: | P12000084035 |
| FEI/EIN Number |
46-1133252
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1503 Buenos Aires Blvd, The Villages, FL, 32159, US |
| Mail Address: | 1503 Buenos Aires Blvd, The Villages, FL, 32159, US |
| ZIP code: | 32159 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578800454 | 2013-01-11 | 2018-05-29 | 121A LAGRANDE BLVD STE A, LADY LAKE, FL, 321591302, US | 1503 BUENOS AIRES BLVD STE 180, THE VILLAGES, FL, 32159, US | |||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 352-753-0581 |
| Fax | 3527532078 |
| Phone | +1 352-323-1482 |
| Fax | 3522590748 |
Authorized person
| Name | DR. BERNADETTE SANTOS |
| Role | OWNER |
| Phone | 3527530581 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| License Number | ME81152 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 143942097 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD PROVIDER NUMBER |
| Number | 51617 |
| State | FL |
| Issuer | TRICARE PROVIDER NUMBER |
| Number | 143942097 |
| State | FL |
| Issuer | RAILROAD MEDICARE PROVIDER NUMBER |
| Number | P00601026 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BERNADETTE SANTOS, MD, PA 401(K) PLAN | 2019 | 461133252 | 2020-06-23 | BERNADETTE SANTOS, MD, PA | 4 | |||||||||||||
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| BERNADETTE SANTOS, MD, PA 401(K) PLAN | 2018 | 461133252 | 2019-09-20 | BERNADETTE SANTOS, MD, PA | 4 | |||||||||||||
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| BERNADETTE SANTOS, MD, PA 401(K) PLAN | 2017 | 461133252 | 2018-09-05 | BERNADETTE SANTOS, MD, PA | 3 | |||||||||||||
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| BERNADETTE SANTOS, MD, PA 401(K) PLAN | 2016 | 461133252 | 2017-06-15 | BERNADETTE SANTOS, MD, PA | 2 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| SANTOS BERNADETTE | President | 1503 Buenos Aires Blvd, The Villages, FL, 32159 |
| SANTOS BERNADETTE | Vice President | 1503 Buenos Aires Blvd, The Villages, FL, 32159 |
| SANTOS BERNADETTE | Secretary | 1503 Buenos Aires Blvd, The Villages, FL, 32159 |
| SANTOS BERNADETTE | Treasurer | 1503 Buenos Aires Blvd, The Villages, FL, 32159 |
| SANTOS BERNADETTE | Agent | 1503 Buenos Aires Blvd, The Villages, FL, 32159 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2020-03-07 | 1503 Buenos Aires Blvd, Bldg. 180, The Villages, FL 32159 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-07 | 1503 Buenos Aires Blvd, Bldg. 180, The Villages, FL 32159 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-22 | 1503 Buenos Aires Blvd, Bldg. 180, The Villages, FL 32159 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-02-06 |
| ANNUAL REPORT | 2021-03-04 |
| ANNUAL REPORT | 2020-03-07 |
| ANNUAL REPORT | 2019-02-22 |
| ANNUAL REPORT | 2018-04-01 |
| ANNUAL REPORT | 2017-02-26 |
| ANNUAL REPORT | 2016-01-24 |
| ANNUAL REPORT | 2015-01-08 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 9226027004 | 2020-04-09 | 0491 | PPP | 1503 Buenos Aires Boulevard #180, LADY LAKE, FL, 32159-6821 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
