| Entity Name: | LAKESIDE SURGERY, LTD. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Partnership |
| Status: | Inactive |
| Date Filed: | 25 Jun 1997 (28 years ago) |
| Date of dissolution: | 20 Dec 2021 (3 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 20 Dec 2021 (3 years ago) |
| Document Number: | A97000001411 |
| FEI/EIN Number | 75-2714441 |
| Address: | 1825 N. MILLS AVE., ORLANDO, FL 32803 |
| Mail Address: | 1825 N. MILLS AVE., ORLANDO, FL 32803 |
| ZIP code: | 32803 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043265739 | 2006-05-23 | 2008-05-20 | 1825 N MILLS AVE, ORLANDO, FL, 32803, US | 1825 N MILLS AVE, ORLANDO, FL, 32803, US | |||||||||||||||||||||||||||
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| Phone | +1 407-206-2375 |
| Fax | 4072062377 |
Authorized person
| Name | MS. MARGIE A BRILL |
| Role | ADMINISTRATOR |
| Phone | 4072062375 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | WELLCARE |
| Number | 288415 |
| State | FL |
| Issuer | BCBS |
| Number | 97107 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Lehr, John T | Agent | 1825 N. Mills Avenue, Orlando, FL 32803 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2021-12-20 | No data | CONVERSION MEMBER. NON-QUALIFIED CORPORATION WAS LAKESIDE SURGERY, LLC AN ON QUALIF. CONVERSION NUMBER 100000221461 |
| REGISTERED AGENT NAME CHANGED | 2014-01-08 | Lehr, John T | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-08 | 1825 N. Mills Avenue, Orlando, FL 32803 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2000-12-04 | 1825 N. MILLS AVE., ORLANDO, FL 32803 | No data |
| CHANGE OF MAILING ADDRESS | 2000-12-04 | 1825 N. MILLS AVE., ORLANDO, FL 32803 | No data |
| AMENDMENT | 2000-10-19 | No data | No data |
| AMENDMENT AND NAME CHANGE | 2000-08-01 | LAKESIDE SURGERY, LTD. | No data |
| Name | Date |
|---|---|
| Conversion | 2021-12-20 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-01-28 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-01-13 |
| ANNUAL REPORT | 2014-01-08 |
| ANNUAL REPORT | 2013-02-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
