| Entity Name: | AIRLIFE MEDICAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Mar 2005 (20 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 11 Aug 2008 (17 years ago) |
| Document Number: | L05000023053 |
| FEI/EIN Number | 202421123 |
| Address: | 205 MAIN ST, AUBURNDALE, FL, 33823 |
| Mail Address: | 205 MAIN ST, AUBURNDALE, FL, 33823 |
| ZIP code: | 33823 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568464295 | 2005-08-12 | 2021-04-26 | 205 MAIN ST, AUBURNDALE, FL, 338233403, US | 205 MAIN ST, AUBURNDALE, FL, 338233403, US | |||||||||||||||||||||||||
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| Phone | +1 863-965-4410 |
| Fax | 8639654412 |
Authorized person
| Name | MR. RICHARD FRANK BRAUCKMULLER |
| Role | GENERAL MANAGER |
| Phone | 8639654410 |
Taxonomy
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| License Number | 1312636 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 030897800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BRAUCKMULLER RICHARD | Agent | 205 MAIN ST, AUBURNDALE, FL, 33823 |
| Name | Role | Address |
|---|---|---|
| BRAUCKMULLER RICHARD | Managing Member | 205 MAIN ST, AUBURNDALE, FL, 33823 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2016-01-25 | 205 MAIN ST, AUBURNDALE, FL 33823 | No data |
| LC AMENDMENT | 2008-08-11 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-08-11 | 205 MAIN ST, AUBURNDALE, FL 33823 | No data |
| CHANGE OF MAILING ADDRESS | 2008-08-11 | 205 MAIN ST, AUBURNDALE, FL 33823 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-01-08 | BRAUCKMULLER, RICHARD | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-22 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-01-23 |
| ANNUAL REPORT | 2021-01-14 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-01-26 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-01-17 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
