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  5. FOOT CARE STORE, INC.

FOOT CARE STORE, INC.

Company Details

Entity Name: FOOT CARE STORE, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 16 Jan 1996 (29 years ago)
Document Number: P96000005051
FEI/EIN Number 65-0638739
Address: 3281 FAIRLANE FARMS RD., STE 7, WELLINGTON, FL 33414
Mail Address: 3281 FAIRLANE FARMS RD., STE 7, WELLINGTON, FL 33414
ZIP code: 33414
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1912218504 2010-06-29 2016-10-07 3281 FAIRLANE FARMS RD STE 7, WELLINGTON, FL, 334146503, US 3281 FAIRLANE FARMS RD STE 7, WELLINGTON, FL, 334146503, US

Contacts
Phone +1 561-791-1213
Fax 5617919919

Authorized person
Name DR. ROBERT MARK GAYNOR
Role PRESIDENT
Phone 5617217063

Taxonomy
Taxonomy Code 335E00000X - Prosthetic/Orthotic Supplier
License Number 1985
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 003177356A
State GA
Issuer MEDICAID
Number 1740333061
State VA
Issuer MEDICAID
Number 029761501
State FL
Issuer AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS,PROSTHETICS & PEDORTHICS, INC.
Number 0008364940
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FOOT CARE STORE INC 401(K) PROFIT SHARING PLAN & TRUST 2023 650638739 2024-04-25 FOOT CARE STORE INC 68
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 448210
Sponsor’s telephone number 5617911213
Plan sponsor’s address 3281 FAIRLANE FARMS RD STE 7, WELLINGTON, FL, 334146503

Signature of
Role Plan administrator
Date 2024-04-25
Name of individual signing ROBERT GAYNOR
Valid signature Filed with authorized/valid electronic signature
FOOT CARE STORE INC 401(K) PROFIT SHARING PLAN & TRUST 2022 650638739 2023-05-03 FOOT CARE STORE INC 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 448210
Sponsor’s telephone number 5617911213
Plan sponsor’s address 3281 FAIRLANE FARMS RD STE 7, WELLINGTON, FL, 334146503

Signature of
Role Plan administrator
Date 2023-05-03
Name of individual signing ROBERT GAYNOR
Valid signature Filed with authorized/valid electronic signature
FOOT CARE STORE INC 401(K) PROFIT SHARING PLAN & TRUST 2021 650638739 2022-04-05 FOOT CARE STORE INC 66
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 448210
Sponsor’s telephone number 5617911213
Plan sponsor’s address 3281 FAIRLANE FARMS RD STE 7, WELLINGTON, FL, 334146503

Signature of
Role Plan administrator
Date 2022-04-05
Name of individual signing ROBERT GAYNOR
Valid signature Filed with authorized/valid electronic signature
FOOT CARE STORE INC 401(K) PROFIT SHARING PLAN & TRUST 2020 650638739 2021-05-12 FOOT CARE STORE INC 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 448210
Sponsor’s telephone number 5617911213
Plan sponsor’s address 3281 FAIRLANE FARMS RD STE 7, WELLINGTON, FL, 334146503

Signature of
Role Plan administrator
Date 2021-05-12
Name of individual signing ROBERT GAYNOR
Valid signature Filed with authorized/valid electronic signature
FOOT CARE STORE INC 401(K) SHARING PLAN & TRUST 2019 650638739 2020-07-23 FOOT CARE STORE INC 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 448210
Plan sponsor’s address 3281 FAIRLANE FARMS RD STE 7, WELLINGTON, FL, 334146503

Signature of
Role Plan administrator
Date 2020-07-23
Name of individual signing DAWN GAYNOR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-23
Name of individual signing DAWN GAYNOR
Valid signature Filed with authorized/valid electronic signature
FOOT CARE STORE INC 401 K PROFIT SHARING PLAN TRUST 2018 650638739 2019-03-21 FOOT CARE STORE INC 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 448210
Sponsor’s telephone number 5617911213
Plan sponsor’s address 3281 FAIRLANE FARMS RD STE 7, WELLINGTON, FL, 334146503

Signature of
Role Plan administrator
Date 2019-03-21
Name of individual signing ROBERT GAYNOR
Valid signature Filed with authorized/valid electronic signature
FOOT CARE STORE INC 401 K PROFIT SHARING PLAN TRUST 2017 650638739 2018-04-27 FOOT CARE STORE INC 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 448210
Sponsor’s telephone number 5617911213
Plan sponsor’s address 3281 FAIRLANE FARMS RD STE 7, WELLINGTON, FL, 334146503

Signature of
Role Plan administrator
Date 2018-04-27
Name of individual signing ROBERT GAYNOR
Valid signature Filed with authorized/valid electronic signature
FOOT CARE STORE INC 401 K PROFIT SHARING PLAN TRUST 2016 650638739 2017-07-11 FOOT CARE STORE INC 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 448210
Sponsor’s telephone number 5617911213
Plan sponsor’s address 3281 FAIRLANE FARMS RD STE 7, WELLINGTON, FL, 334146503

Signature of
Role Plan administrator
Date 2017-07-11
Name of individual signing ROBERT GAYNOR
Valid signature Filed with authorized/valid electronic signature
FOOT CARE STORE INC 401 K PROFIT SHARING PLAN TRUST 2015 650638739 2016-06-16 FOOT CARE STORE INC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 448210
Sponsor’s telephone number 5617911213
Plan sponsor’s address 3281 FAIRLANE FARMS RD STE 7, WELLINGTON, FL, 334146503

Signature of
Role Plan administrator
Date 2016-06-16
Name of individual signing ROBERT GAYNOR
Valid signature Filed with authorized/valid electronic signature
FOOT CARE STORE INC 401 K PROFIT SHARING PLAN TRUST 2014 650638739 2015-06-18 FOOT CARE STORE INC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 448210
Sponsor’s telephone number 5617911213
Plan sponsor’s address 3400 FAIRLANE FARMS RD, WELLINGTON, FL, 334148751

Signature of
Role Plan administrator
Date 2015-06-18
Name of individual signing DAWN GAYNOR
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ROBERT, GAYNOR MPRES Agent 3281 FAIRLANE FARMS RD., STE 7, WELLINGTON, FL 33414

Vice President

Name Role Address
GAYNOR, DAWN Vice President 3281 FAIRLANE FARMS RD., STE 7 WELLINGTON, FL 33414

President

Name Role Address
GAYNOR, ROBERT M President 3281 FAIRLANE FARMS RD., STE 7 WELLINGTON, FL 33414

Secretary

Name Role Address
GAYNOR, DAWN L Secretary 3281 FAIRLANE FARMS RD., STE 7 WELLINGTON, FL 33414

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G15000014782 DIA-FOOT ACTIVE 2015-02-10 2025-12-31 No data 3281 FAIRLANE FARMS RD STE 7, WELLINGTON, FL, 33414

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2016-02-23 3281 FAIRLANE FARMS RD., STE 7, WELLINGTON, FL 33414 No data
CHANGE OF PRINCIPAL ADDRESS 2015-06-11 3281 FAIRLANE FARMS RD., STE 7, WELLINGTON, FL 33414 No data
CHANGE OF MAILING ADDRESS 2015-06-11 3281 FAIRLANE FARMS RD., STE 7, WELLINGTON, FL 33414 No data
REGISTERED AGENT NAME CHANGED 2010-04-28 ROBERT, GAYNOR MPRES No data

Documents

Name Date
ANNUAL REPORT 2025-01-06
ANNUAL REPORT 2024-01-09
ANNUAL REPORT 2023-01-09
ANNUAL REPORT 2022-01-07
ANNUAL REPORT 2021-02-05
ANNUAL REPORT 2020-01-23
ANNUAL REPORT 2019-01-31
ANNUAL REPORT 2018-03-12
ANNUAL REPORT 2017-01-06
ANNUAL REPORT 2016-02-23

Related by officers

GAYNOR, ROBERT M

PAIN RELIEF ORTHOTICS INC. SPRING SWINGS INC. DAVIS-GRABOWSKI, INC. DEEGEE INDUSTRIES, INC.

GAYNOR, DAWN L

PAIN RELIEF ORTHOTICS INC. STOCKS & BONDING LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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