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EAR, NOSE & THROAT ASSOCIATES OF LAKE COUNTY, P.A. - Florida Company Profile

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Company Details

Entity Name: EAR, NOSE & THROAT ASSOCIATES OF LAKE COUNTY, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 01 Jan 1979 (47 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 14 Dec 2001 (24 years ago)
Document Number: 605776
FEI/EIN Number 591872806
Address: 2038 CLASSIQUE LANE, TAVARES, FL, 32778
Mail Address: 2038 CLASSIQUE LANE, TAVARES, FL, 32778
ZIP code: 32778
City: Tavares
County: Lake
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
BURGOS DON S Director 2038 CLASSIQUE LANE, TAVARES, FL, 32778
BURGOS DON S President 2038 CLASSIQUE LANE, TAVARES, FL, 32778
BURGOS DON S Treasurer 2038 CLASSIQUE LANE, TAVARES, FL, 32778
KOLTUN JEFFREY M Agent 150 SPARTAN DRIVE, MAITLAND, FL, 32751

National Provider Identifier

NPI Number:
1639372634

Authorized Person:

Name:
DON S. BURGOS
Role:
DOCTOR
Phone:

Taxonomy:

Selected Taxonomy:
207Y00000X - Otolaryngology Physician
Is Primary:
Yes

Contacts:

Fax:
3527420228

Form 5500 Series

Employer Identification Number (EIN):
591872806
Plan Year:
2010
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
4
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2015-03-10 KOLTUN, JEFFREY M -
REGISTERED AGENT ADDRESS CHANGED 2015-03-10 150 SPARTAN DRIVE, SUITE 100, MAITLAND, FL 32751 -
CHANGE OF PRINCIPAL ADDRESS 2012-02-09 2038 CLASSIQUE LANE, TAVARES, FL 32778 -
CHANGE OF MAILING ADDRESS 2012-02-09 2038 CLASSIQUE LANE, TAVARES, FL 32778 -
NAME CHANGE AMENDMENT 2001-12-14 EAR, NOSE & THROAT ASSOCIATES OF LAKE COUNTY, P.A. -

Documents

Name Date
ANNUAL REPORT 2024-04-30
ANNUAL REPORT 2023-04-14
ANNUAL REPORT 2022-04-05
ANNUAL REPORT 2021-04-21
ANNUAL REPORT 2020-02-21
ANNUAL REPORT 2019-03-28
ANNUAL REPORT 2018-02-06
ANNUAL REPORT 2017-04-25
ANNUAL REPORT 2016-02-24
ANNUAL REPORT 2015-03-10

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Date of last update: 02 Aug 2025

Sources: Florida Department of State