| Entity Name: | EPSALTOS HEALTHCARE, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 May 2015 (10 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 30 Sep 2022 (2 years ago) |
| Document Number: | P15000042220 |
| FEI/EIN Number | 47-4036587 |
| Address: | 7657 CITA LANE, NEW PORT RICHEY, FL, 34653, US |
| Mail Address: | 7657 CITA LANE, NEW PORT RICHEY, FL, 34653, US |
| ZIP code: | 34653 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174975106 | 2016-07-01 | 2020-10-25 | 7657 CITA LN UNIT 101, NEW PORT RICHEY, FL, 346536221, US | 7657 CITA LN UNIT 101, NEW PORT RICHEY, FL, 346536221, US | |||||||||||||||||||||||||||
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| Phone | +1 727-233-1118 |
| Fax | 7273728338 |
| Phone | +1 908-209-4795 |
Authorized person
| Name | DR. WAEL FATHY GAYD FALTAS |
| Role | PRESIDENT |
| Phone | 9082094795 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | IM |
| Number | ME1111714 |
| State | GU |
| Name | Role | Address |
|---|---|---|
| Faltas wael fDr. | Agent | 4859 Quill CT, Palm Harbor, FL, 34685 |
| Name | Role | Address |
|---|---|---|
| FALTAS WAEL | President | 4859 QUILL COURT, PALM HARBOR, FL, 34685 |
| Name | Role | Address |
|---|---|---|
| FALTAS WAEL | Director | 4859 QUILL COURT, PALM HARBOR, FL, 34685 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000115647 | CLINIC TIME INTERNAL MEDICINE AND PRIMARY CARE | ACTIVE | 2016-10-24 | 2026-12-31 | No data | 4859 QUILL CT, PALM HARBOR, FL, 34685 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-09-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-08 | 4859 Quill CT, Palm Harbor, FL 34685 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-02-08 | 7657 CITA LANE, Suite 101, NEW PORT RICHEY, FL 34653 | No data |
| CHANGE OF MAILING ADDRESS | 2021-02-08 | 7657 CITA LANE, Suite 101, NEW PORT RICHEY, FL 34653 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-04-21 | Faltas, wael fathy gayd, Dr. | No data |
| AMENDMENT | 2016-03-15 | No data | No data |
| AMENDMENT | 2015-07-29 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-12 |
| ANNUAL REPORT | 2024-01-17 |
| ANNUAL REPORT | 2023-01-20 |
| REINSTATEMENT | 2022-09-30 |
| ANNUAL REPORT | 2021-02-08 |
| ANNUAL REPORT | 2020-05-11 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-21 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-03-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
