| Entity Name: | PRO-TECH SPORTS MEDICINE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 17 Feb 1999 (26 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P99000015657 |
| FEI/EIN Number | 650901151 |
| Address: | 7241 SW 63 AVENUE, SUITE 102-A, SOUTH MIAMI, FL, 33143 |
| Mail Address: | 7241 SW 63 AVENUE, SUITE 102-A, SOUTH MIAMI, FL, 33143 |
| ZIP code: | 33143 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801098769 | 2007-06-04 | 2009-03-19 | 7241 SW 63RD AVE, SUITE 102A, SOUTH MIAMI, FL, 331434838, US | 7241 SW 63RD AVE, SUITE 102A, SOUTH MIAMI, FL, 331434838, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 305-668-2860 |
| Fax | 3056682862 |
Authorized person
| Name | MS. MELISSA LEEDS |
| Role | ADMINISTRATOR |
| Phone | 3056682860 |
Taxonomy
| Taxonomy Code | 213EP1101X - Primary Podiatric Medicine Podiatrist |
| License Number | P02792 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 213ES0000X - Sports Medicine Podiatrist |
| License Number | P02027 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS GROUP # |
| Number | 45915 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LEEDS LINDA | Agent | 11655 OLD CUTLER RD, CORAL GABLES, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| LOSITO JAMES D | President | 7241 SW 63 AVENUE SUITE 102-A, SOUTH MIAMI, FL, 33143 |
| Name | Role | Address |
|---|---|---|
| LEEDS MELISSA | Vice President | 7241 SW 63 AVENUE SUITE 102-A, SOUTH MIAMI, FL, 33143 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-02 | 7241 SW 63 AVENUE, SUITE 102-A, SOUTH MIAMI, FL 33143 | No data |
| CHANGE OF MAILING ADDRESS | 2009-04-02 | 7241 SW 63 AVENUE, SUITE 102-A, SOUTH MIAMI, FL 33143 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-05-11 | LEEDS, LINDA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-05-11 | 11655 OLD CUTLER RD, CORAL GABLES, FL 33156 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-02-23 |
| ANNUAL REPORT | 2010-03-15 |
| ANNUAL REPORT | 2009-04-02 |
| ANNUAL REPORT | 2008-04-14 |
| ANNUAL REPORT | 2007-04-26 |
| Reg. Agent Change | 2006-05-11 |
| ANNUAL REPORT | 2006-04-28 |
| ANNUAL REPORT | 2005-04-12 |
| ANNUAL REPORT | 2004-02-19 |
| ANNUAL REPORT | 2003-04-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
