| Entity Name: | GAINESVILLE SLEEP LAB, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 31 Aug 2005 (19 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L05000086258 |
| FEI/EIN Number | 203458773 |
| Mail Address: | 1834 SW 1ST AVE., STE 101, OCALA, FL, 34471 |
| Address: | 9200 NW 36TH PLACE SUITE B, GAINESVILLE, FL, 32606 |
| ZIP code: | 32606 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417378753 | 2014-01-03 | 2014-01-03 | 1834 SW 1ST AVE, SUITE 301, OCALA, FL, 344718100, US | 1834 SW 1ST AVE, SUITE 301, OCALA, FL, 344718100, US | |||||||||||||||||||||||||
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| Phone | +1 352-671-9924 |
| Fax | 3526719925 |
Authorized person
| Name | MS. FRAN E EVANS |
| Role | OWNER / ADMINISTRATIVE DIRECTOR |
| Phone | 3526719924 |
Taxonomy
| Taxonomy Code | 261QS1200X - Sleep Disorder Diagnostic Clinic/Center |
| License Number | HCC9175 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE ID-TYPE UNSPECIFIED |
| Number | PENDING |
| State | FL |
| Name | Role |
|---|---|
| OCALA LUNG & CRITICAL CARE ASSOCIATES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| KOHLI NAGESH D | Managing Member | 2020 SW 44TH LANE, OCALA, FL, 34474 |
| MITRA PURUSHOTTAM | Managing Member | 2170 SW 37TH STREET ROAD, OCALA, FL, 34474 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-09-18 | 9200 NW 36TH PLACE SUITE B, GAINESVILLE, FL 32606 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-04-19 | OCALA LUNG & CRITICAL CARE ASSOCIATES, INC | No data |
| CHANGE OF MAILING ADDRESS | 2011-02-18 | 9200 NW 36TH PLACE SUITE B, GAINESVILLE, FL 32606 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-02-18 | 1834 SW 1ST AVENUE STE 101, OCALA, FL 34471 | No data |
| CANCEL ADM DISS/REV | 2006-09-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-05 |
| ANNUAL REPORT | 2017-03-13 |
| ANNUAL REPORT | 2016-04-07 |
| ANNUAL REPORT | 2015-02-25 |
| ANNUAL REPORT | 2014-04-22 |
| ANNUAL REPORT | 2013-02-20 |
| ANNUAL REPORT | 2012-02-21 |
| ANNUAL REPORT | 2011-04-19 |
| ANNUAL REPORT | 2011-02-18 |
| ANNUAL REPORT | 2010-04-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
