| Entity Name: | PEDIATRIC CENTERS OF LEE COUNTY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 01 Apr 1993 (32 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 22 Sep 2021 (3 years ago) |
| Document Number: | P93000024257 |
| FEI/EIN Number | 65-0417446 |
| Address: | 222 Plaza Drive, Lehigh Acres, FL 33936 |
| Mail Address: | 222 Plaza Drive, Lehigh Acres, FL 33936 |
| ZIP code: | 33936 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235271669 | 2007-02-13 | 2015-08-04 | 222 PLAZA DR, LEHIGH ACRES, FL, 339366018, US | 222 PLAZA DR, LEHIGH ACRES, FL, 339366018, US | |||||||||||||||||||||
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| Phone | +1 239-368-5437 |
| Fax | 2393690880 |
Authorized person
| Name | MR. CARLOS L MORALES |
| Role | OFFICE MANAGER |
| Phone | 2392789983 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 255363501 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| OSVALDO R. MORALES DEL CASTILLO MD | Agent | 222 Plaza Drive, Lehigh Acres, FL 33936 |
| Name | Role | Address |
|---|---|---|
| MORALES DEL CASTILLO, OSVALDO R | Manager | 222 Plaza Drive, Lehigh Acres, FL 33936 |
| Name | Role | Address |
|---|---|---|
| MORALES DEL CASTILLO, OSVALDO R | Director | 222 Plaza Drive, Lehigh Acres, FL 33936 |
| Name | Role | Address |
|---|---|---|
| MORALES DEL CASTILLO, OSVALDO JESUS | Vice President | 23 GREENWOOD AVENUE, Lehigh Acres, FL 33936 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2021-09-22 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2018-03-09 | 222 Plaza Drive, Lehigh Acres, FL 33936 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-03-09 | 222 Plaza Drive, Lehigh Acres, FL 33936 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-09 | 222 Plaza Drive, Lehigh Acres, FL 33936 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-03-09 | OSVALDO R. MORALES DEL CASTILLO MD | No data |
| NAME CHANGE AMENDMENT | 2002-11-13 | PEDIATRIC CENTERS OF LEE COUNTY, INC. | No data |
| AMENDMENT AND NAME CHANGE | 2002-01-08 | OSVALDO R. MORALES DEL CASTILLO, M.D., INC. | No data |
| REINSTATEMENT | 1995-09-22 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1995-08-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-29 |
| ANNUAL REPORT | 2023-04-07 |
| ANNUAL REPORT | 2022-04-04 |
| ANNUAL REPORT | 2021-04-18 |
| ANNUAL REPORT | 2020-06-09 |
| ANNUAL REPORT | 2019-03-19 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-03-01 |
| ANNUAL REPORT | 2016-03-09 |
| ANNUAL REPORT | 2015-01-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
