| Entity Name: | CYPRESS PODIATRY ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 06 Jul 1999 (26 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P99000061878 |
| FEI/EIN Number | 593590327 |
| Address: | 1304 Mirror Terrace, NW, WINTER HAVEN, FL, 33881, US |
| Mail Address: | 1304 Mirror Terrace, NW, WINTER HAVEN, FL, 33881, US |
| ZIP code: | 33881 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043321763 | 2006-08-31 | 2011-01-11 | 575 AVENUE K SE, WINTER HAVEN, FL, 338804215, US | 575 AVENUE K SE, WINTER HAVEN, FL, 338804215, US | |||||||||||||||||||||
|
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| Phone | +1 863-293-1950 |
| Fax | 8632931899 |
Authorized person
| Name | DR. JAMES E KOON |
| Role | PRESIDENT |
| Phone | 8632931950 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | GROUP NPI |
| Number | 1403321763 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KOON JAMES E | Agent | 1304 Mirror Terrace, NW, WINTER HAVEN, FL, 33881 |
| Name | Role | Address |
|---|---|---|
| KOON JAMES E | Director | 1304 Mirror Terrace, NW, WINTER HAVEN, FL, 33881 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-04-16 | 1304 Mirror Terrace, NW, WINTER HAVEN, FL 33881 | No data |
| CHANGE OF MAILING ADDRESS | 2016-04-16 | 1304 Mirror Terrace, NW, WINTER HAVEN, FL 33881 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-16 | 1304 Mirror Terrace, NW, WINTER HAVEN, FL 33881 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-01-11 | KOON, JAMES ED.P.M. | No data |
| CANCEL ADM DISS/REV | 2003-10-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-16 |
| ANNUAL REPORT | 2015-01-12 |
| ANNUAL REPORT | 2014-01-21 |
| ANNUAL REPORT | 2013-01-28 |
| ANNUAL REPORT | 2012-01-07 |
| ANNUAL REPORT | 2011-01-11 |
| ANNUAL REPORT | 2010-02-16 |
| ANNUAL REPORT | 2009-02-23 |
| ANNUAL REPORT | 2008-01-15 |
| ANNUAL REPORT | 2007-01-08 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
