| Entity Name: | FAKLIS ORTHOPEDIC SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 14 Jun 1994 (31 years ago) |
| Document Number: | P94000045755 |
| FEI/EIN Number | 59-3245272 |
| Address: | 139 E TARPON AVE, TARPON SPRINGS, FL 34689 |
| Mail Address: | 139 E TARPON AVE, TARPON SPRINGS, FL 34689 |
| ZIP code: | 34689 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295895795 | 2006-12-12 | 2007-11-12 | 139 E TARPON AVE, TARPON SPRINGS, FL, 346893451, US | 139 E TARPON AVE, TARPON SPRINGS, FL, 346893451, US | |||||||||||||||||||||||||
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| Phone | +1 727-938-1525 |
| Fax | 7279381669 |
Authorized person
| Name | VASILE G FAKLIS |
| Role | OWNER, OTHOTIST |
| Phone | 7279381525 |
Taxonomy
| Taxonomy Code | 335E00000X - Prosthetic/Orthotic Supplier |
| License Number | ORT 84 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 021837500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FAKLIS, IRENE K | Agent | 139 E TARPON AVE, TARPON SPRINGS, FL 34689 |
| Name | Role | Address |
|---|---|---|
| FAKLIS, VASILE G | President | 139 E TARPON AVE, TARPON SPRINGS, FL 34689 |
| Name | Role | Address |
|---|---|---|
| FAKLIS, VASILE G | Director | 139 E TARPON AVE, TARPON SPRINGS, FL 34689 |
| FAKLIS, IRENE K | Director | 139 E TARPON AVE, TARPON SPRINGS, FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 1998-05-11 | FAKLIS, IRENE K | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1998-05-11 | 139 E TARPON AVE, TARPON SPRINGS, FL 34689 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-04-15 |
| ANNUAL REPORT | 2020-02-21 |
| ANNUAL REPORT | 2019-01-15 |
| ANNUAL REPORT | 2018-03-11 |
| ANNUAL REPORT | 2017-03-05 |
| ANNUAL REPORT | 2016-01-26 |
| ANNUAL REPORT | 2015-02-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
