| Entity Name: | PHOENIX MEDICAL LABORATORY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
PHOENIX MEDICAL LABORATORY, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 02 Mar 2004 (21 years ago) |
| Date of dissolution: | 25 Sep 2009 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (16 years ago) |
| Document Number: | L04000016454 |
| FEI/EIN Number |
331086435
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 11220 METRO PARKWAY, UNIT 1, FT. MYERS, FL, 33966 |
| Mail Address: | 11220 METRO PARKWAY, UNIT 1, FT. MYERS, FL, 33966 |
| ZIP code: | 33966 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841280815 | 2005-10-21 | 2008-05-29 | 12701 COMMONWEALTH DR, SUITE 6, FORT MYERS, FL, 339138626, US | 12701 COMMONWEALTH DR, SUITE 6, FORT MYERS, FL, 339138626, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 239-768-0600 |
| Fax | 2397680711 |
Authorized person
| Name | MR. ROBERT P GASPARINI |
| Role | PRESIDENT |
| Phone | 2397680600 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | CLIA10D1023653 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 8000017185 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 8000019289 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS FL |
| Number | L9266 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ RICHARD | Manager | 11220 METRO PARKWAY, UNIT 1, FT. MYERS, FL, 33966 |
| FERNANDEZ RICHARD | Agent | 11220 METRO PARKWAY, UNIT 1, FT. MYERS, FL, 33966 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2006-07-19 | 11220 METRO PARKWAY, UNIT 1, FT. MYERS, FL 33966 | - |
| CHANGE OF MAILING ADDRESS | 2006-07-19 | 11220 METRO PARKWAY, UNIT 1, FT. MYERS, FL 33966 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2006-07-19 | 11220 METRO PARKWAY, UNIT 1, FT. MYERS, FL 33966 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-04-30 |
| ANNUAL REPORT | 2007-01-04 |
| ANNUAL REPORT | 2006-07-19 |
| ANNUAL REPORT | 2005-04-19 |
| Florida Limited Liabilites | 2004-03-02 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
