| Entity Name: | EXCEL RESPIRATORY SOLUTIONS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 15 Feb 2005 (20 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | L05000015711 |
| FEI/EIN Number | 202676283 |
| Address: | 334 3RD ST. NW, WINTER HAVEN, FL, 33881, UN |
| Mail Address: | 334 3RD ST. NW, WINTER HAVEN, FL, 33881 |
| ZIP code: | 33881 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447309141 | 2007-01-10 | 2008-03-05 | 334 3RD ST NW, WINTER HAVEN, FL, 338814002, US | 334 3RD ST NW, WINTER HAVEN, FL, 338814002, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 863-299-2500 |
| Fax | 8632992511 |
Authorized person
| Name | MR. MARK RANDAL HAGMAN |
| Role | PRESIDENT |
| Phone | 8636983111 |
Taxonomy
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| License Number | 3204482 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSSBLUE SHIELD |
| Number | R9798 |
| State | FL |
| Issuer | FL MEDICAL EQUIPMENT LIC |
| Number | 1312801 |
| State | FL |
| Issuer | WINTER HAVEN OCCP LIC |
| Number | 24002 |
| State | FL |
| Issuer | FL MEDICAL OXYGEN PERMIT |
| Number | 3204482 |
| State | FL |
| Issuer | POLK COUNTY OCCP LIC |
| Number | 99700007892 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HAGMAN MARK | Agent | 334 3RD ST. NW, WINTER HAVEN, FL, 33881 |
| Name | Role | Address |
|---|---|---|
| HAGMAN MARK | President | 334 3RD ST. NW, WINTER HAVEN, FL, 33881 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-02-25 | 334 3RD ST. NW, WINTER HAVEN, FL 33881 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-03-19 | 334 3RD ST. NW, WINTER HAVEN, FL 33881 UN | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-28 | 334 3RD ST. NW, WINTER HAVEN, FL 33881 UN | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-02-25 |
| ANNUAL REPORT | 2012-03-19 |
| ANNUAL REPORT | 2011-06-03 |
| ANNUAL REPORT | 2010-04-28 |
| ANNUAL REPORT | 2009-01-15 |
| ANNUAL REPORT | 2008-07-22 |
| ANNUAL REPORT | 2007-07-23 |
| ANNUAL REPORT | 2006-07-12 |
| Florida Limited Liability | 2005-02-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
