| Entity Name: | JOHN T. MOOR, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 16 Oct 1992 (32 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 17 Jan 2013 (12 years ago) |
| Document Number: | V71786 |
| FEI/EIN Number | 59-3146142 |
| Address: | 2446 S TAMIAMI TRAIL, 3RD FLOOR, SARASOTA, FL 34239 |
| Mail Address: | 2446 S TAMIAMI TRAIL, 3RD FLOOR, SARASOTA, FL 34239 |
| ZIP code: | 34239 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144361981 | 2007-02-12 | 2023-08-14 | 2446 S TAMIAMI TRL, SARASOTA, FL, 342393809, US | 2446 S TAMIAMI TRL, SARASOTA, FL, 342393809, US | |||||||||||||||||||||||||
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| Phone | +1 941-957-1500 |
| Fax | 9419573059 |
Authorized person
| Name | DR. JOHN TIMOTHY MOOR |
| Role | PRESIDENT |
| Phone | 9419571500 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME0055341 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 061759801 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN T MOOR MD PA 401(K) PROFIT SHARING PLAN | 2010 | 593146142 | 2011-08-05 | JOHN T. MOOR, M.D., P.A. | 8 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 593146142 |
| Plan administrator’s name | JOHN T. MOOR, M.D., P.A. |
| Plan administrator’s address | 2446 S TAMIAMI TRIAL 3RD FLOOR, SARASOTA, FL, 34230 |
| Administrator’s telephone number | 9419571500 |
Signature of
| Role | Plan administrator |
| Date | 2011-08-05 |
| Name of individual signing | KRISTA MOOR |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| GASSMAN, ALAN S | Agent | 1245 COURT STREET, 102, CLEARWATER, FL 33756 |
| Name | Role | Address |
|---|---|---|
| MOOR, JOHN TMD | President | 2446 S TAMIAMI TRAIL, 3RD FLOOR, SARASOTA, FL 34239 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000014937 | A KNEE AND SHOULDER CENTER | ACTIVE | 2023-01-31 | 2028-12-31 | No data | 2446 S TAMIAMI TRAIL, SARASOTA, FL, 34239 |
| G23000015056 | ADVANCED SPORTSMEDICINE CENTER | ACTIVE | 2023-01-31 | 2028-12-31 | No data | 2446 S TAMIAMI TRAIL, SARASOTA, FL, 34239 |
| G19000086894 | ADVANCED SPORTSMEDICINE CENTER | EXPIRED | 2019-08-16 | 2024-12-31 | No data | 2446 SOUTH TAMIAMI TRAIL, SARASOTA, FL, 34239 |
| G19000086900 | A KNEE AND SHOULDER CENTER | EXPIRED | 2019-08-16 | 2024-12-31 | No data | 2446 SOUTH TAMIAMI TRAIL, SARASOTA, FL, 34239 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2013-01-17 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-08-03 | 2446 S TAMIAMI TRAIL, 3RD FLOOR, SARASOTA, FL 34239 | No data |
| CHANGE OF MAILING ADDRESS | 2009-08-03 | 2446 S TAMIAMI TRAIL, 3RD FLOOR, SARASOTA, FL 34239 | No data |
| CANCEL ADM DISS/REV | 2006-07-06 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-07-06 | 1245 COURT STREET, 102, CLEARWATER, FL 33756 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-01-20 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-03-29 |
| ANNUAL REPORT | 2018-02-02 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-03-08 |
| ANNUAL REPORT | 2015-02-02 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
