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ALL PODIATRY GROUP, INC. - Florida Company Profile

Company Details

Entity Name: ALL PODIATRY GROUP, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

ALL PODIATRY GROUP, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.

Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 12 May 1998 (27 years ago)
Date of dissolution: 30 Dec 2024 (3 months ago)
Last Event: CONVERSION
Event Date Filed: 30 Dec 2024 (3 months ago)
Document Number: P98000043559
FEI/EIN Number 593509645

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 15815 SHADDOCK DRIVE, UNIT 130, WINTER GARDEN, FL, 34787, US
Mail Address: 15815 SHADDOCK DRIVE, UNIT 130, WINTER GARDEN, FL, 34787, US
ZIP code: 34787
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1437207933 2007-01-08 2024-02-19 15815 SHADDOCK DR STE 130, WINTER GARDEN, FL, 347875773, US 15815 SHADDOCK DR STE 130, WINTER GARDEN, FL, 347875773, US

Contacts

Phone +1 813-400-1119
Fax 8137019132
Phone +1 407-605-2321
Fax 4076714155

Authorized person

Name JESSICA TITUS
Role CREDENTIALING COORDINATOR
Phone 8134001140

Taxonomy

Taxonomy Code 213E00000X - Podiatrist
Is Primary No
Taxonomy Code 213EP0504X - Public Medicine Podiatrist
Is Primary No
Taxonomy Code 213EP1101X - Primary Podiatric Medicine Podiatrist
Is Primary No
Taxonomy Code 213ES0000X - Sports Medicine Podiatrist
Is Primary No
Taxonomy Code 213ES0103X - Foot & Ankle Surgery Podiatrist
License Number PO774
State FL
Is Primary No
Taxonomy Code 213ES0103X - Foot & Ankle Surgery Podiatrist
Is Primary Yes
Taxonomy Code 213ES0131X - Foot Surgery Podiatrist
Is Primary No

Other Provider Identifiers

Issuer GHI
Number 6201906
State FL
Issuer BLUE CROSS BLUE SHIELD
Number 40483
State FL
Issuer DEPT. OF LABOR
Number 162337800
State FL
Issuer MEDICAID
Number 390408300
State FL
Issuer RAILROAD MEDICARE
Number CG1740
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MODERN FOOT AND ANKLE 401(K) PLAN 2023 593509645 2024-07-26 ALL PODIATRY GROUP, INC. 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2022-01-01
Business code 621391
Sponsor’s telephone number 6306317170
Plan sponsor’s address 15815 SHADDOCK DRIVE, UNIT 130, WINTER GARDEN, FL, 34787

Plan administrator’s name and address

Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of

Role Plan administrator
Date 2024-07-26
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
MODERN FOOT AND ANKLE 401(K) PLAN 2022 593509645 2023-06-22 ALL PODIATRY GROUP, INC. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2022-01-01
Business code 621391
Sponsor’s telephone number 6306317170
Plan sponsor’s address 15815 SHADDOCK DRIVE, UNIT 130, WINTER GARDEN, FL, 34787

Plan administrator’s name and address

Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of

Role Plan administrator
Date 2023-06-22
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
PATEL VIVEK President 15815 SHADDOCK DRIVE, WINTER GARDEN, FL, 34787
HAKKY MICHAEL Chief Financial Officer 15815 SHADDOCK DRIVE, WINTER GARDEN, FL, 34787
SIEGEL ADAM CRO 15815 SHADDOCK DRIVE, WINTER GARDEN, FL, 34787
ZURI MICHAEL Othe 15815 SHADDOCK DRIVE, WINTER GARDEN, FL, 34787
Hakky Michael Agent 201 MORAY LANE, WINTER PARK, FL, 32792

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000102572 MODERN FOOT & ANKLE ACTIVE 2021-08-06 2026-12-31 - 2511 W. DR. MARTIN LUTHER KING BLVD, TAMPA, FL, 33607
G20000150297 ADVANCED FOOT & ANKLE ACTIVE 2020-11-24 2025-12-31 - 2511 W DR. MARTIN LUTHER KING BLVD, TAMPA, FL, 33607
G20000150300 PRISM PODIATRY ACTIVE 2020-11-24 2025-12-31 - 2511 W DR MARTIN LUTHER KING BLVD, TAMPA, FL, 33607

Events

Event Type Filed Date Value Description
CONVERSION 2024-12-30 - CONVERSION MEMBER. RESULTING CORPORATION WAS L24000007686. CONVERSION NUMBER 300000263413
REGISTERED AGENT NAME CHANGED 2024-02-06 Hakky, Michael -
REGISTERED AGENT ADDRESS CHANGED 2024-02-06 201 MORAY LANE, SUITE B, WINTER PARK, FL 32792 -
CHANGE OF PRINCIPAL ADDRESS 2022-01-27 15815 SHADDOCK DRIVE, UNIT 130, WINTER GARDEN, FL 34787 -
CHANGE OF MAILING ADDRESS 2022-01-27 15815 SHADDOCK DRIVE, UNIT 130, WINTER GARDEN, FL 34787 -

Documents

Name Date
ANNUAL REPORT 2024-02-06
ANNUAL REPORT 2023-04-14
AMENDED ANNUAL REPORT 2022-09-03
AMENDED ANNUAL REPORT 2022-03-02
ANNUAL REPORT 2022-01-27
ANNUAL REPORT 2021-01-04
ANNUAL REPORT 2020-01-20
ANNUAL REPORT 2019-02-11
ANNUAL REPORT 2018-04-09
ANNUAL REPORT 2017-02-10

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1412527107 2020-04-10 0455 PPP 2511 DR MARTIN LUTHER KING JR BLVD, TAMPA, FL, 33607-6301
Loan Status Date 2020-12-17
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 154952
Loan Approval Amount (current) 154952
Undisbursed Amount 0
Franchise Name -
Lender Location ID 17715
Servicing Lender Name The Bank of Tampa
Servicing Lender Address 601 Bayshore Blvd, TAMPA, FL, 33606-2747
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address TAMPA, HILLSBOROUGH, FL, 33607-6301
Project Congressional District FL-14
Number of Employees 13
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 17715
Originating Lender Name The Bank of Tampa
Originating Lender Address TAMPA, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 155784.07
Forgiveness Paid Date 2020-11-03
6616848306 2021-01-27 0455 PPS 2511 W Dr Martin Luther King Jr Blvd, Tampa, FL, 33607-6301
Loan Status Date 2021-09-21
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 154952
Loan Approval Amount (current) 154952
Undisbursed Amount 0
Franchise Name -
Lender Location ID 17715
Servicing Lender Name The Bank of Tampa
Servicing Lender Address 601 Bayshore Blvd, TAMPA, FL, 33606-2747
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Tampa, HILLSBOROUGH, FL, 33607-6301
Project Congressional District FL-14
Number of Employees 13
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 17715
Originating Lender Name The Bank of Tampa
Originating Lender Address TAMPA, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 155809.54
Forgiveness Paid Date 2021-08-20

Date of last update: 03 Mar 2025

Sources: Florida Department of State