| Entity Name: | LI'L SUNSHINE SMILES DENTISTRY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Apr 2019 (6 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 11 Dec 2022 (2 years ago) |
| Document Number: | P19000033377 |
| FEI/EIN Number | 83-4489985 |
| Address: | 12950 RACETRACK RD, TAMPA, FL, 33626, US |
| Mail Address: | 12950 RACETRACK RD, TAMPA, FL, 33626, US |
| ZIP code: | 33626 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154977528 | 2019-08-12 | 2019-08-12 | 4904 EBENSBURG DR, TAMPA, FL, 336471381, US | 12950 RACE TRACK RD STE 109, TAMPA, FL, 336261304, US | |||||||||||||||||||
|
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| Phone | +1 719-289-1799 |
Authorized person
| Name | DR. CATALINA BOTERO |
| Role | DDS/PRESIDENT |
| Phone | 7192891799 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 023572000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BOTERO CATALINA | Agent | 12950 RACETRACK RD, TAMPA, FL, 33626 |
| Name | Role | Address |
|---|---|---|
| BOTERO CATALINA | President | 12950 RACETRACK RD, TAMPA, FL, 33626 |
| Name | Role | Address |
|---|---|---|
| BOTERO CATALINA | Vice President | 12950 RACETRACK RD, TAMPA, FL, 33626 |
| Name | Role | Address |
|---|---|---|
| BOTERO CATALINA | Secretary | 12950 RACETRACK RD, TAMPA, FL, 33626 |
| Name | Role | Address |
|---|---|---|
| BOTERO CATALINA | Treasurer | 12950 RACETRACK RD, TAMPA, FL, 33626 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-12-11 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-12-11 | BOTERO, CATALINA | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-30 | 12950 RACETRACK RD, SUITE 109, TAMPA, FL 33626 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-02-24 | 12950 RACETRACK RD, SUITE 109, TAMPA, FL 33626 | No data |
| CHANGE OF MAILING ADDRESS | 2020-02-24 | 12950 RACETRACK RD, SUITE 109, TAMPA, FL 33626 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-03-09 |
| REINSTATEMENT | 2022-12-11 |
| ANNUAL REPORT | 2021-07-27 |
| ANNUAL REPORT | 2020-06-30 |
| Domestic Profit | 2019-04-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
