| 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 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 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 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 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 |
| 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 | |||||||||||||||||||||||||||||||
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| 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 |
| 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 |
| 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 |
| 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 |
| 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 | - |
| 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 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1412527107 | 2020-04-10 | 0455 | PPP | 2511 DR MARTIN LUTHER KING JR BLVD, TAMPA, FL, 33607-6301 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6616848306 | 2021-01-27 | 0455 | PPS | 2511 W Dr Martin Luther King Jr Blvd, Tampa, FL, 33607-6301 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Mar 2025
Sources: Florida Department of State
