| Entity Name: | POLK SLEEP DISORDERS L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 22 Sep 2005 (19 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | L05000093272 |
| FEI/EIN Number | 320162783 |
| Address: | 35 LAKE ELBERT DRIVE, WINTER HAVEN, FL, 33880 |
| Mail Address: | 35 LAKE ELBERT DRIVE, WINTER HAVEN, FL, 33880 |
| ZIP code: | 33880 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023064011 | 2006-05-25 | 2014-07-29 | PO BOX 7272, WINTER HAVEN, FL, 338837272, US | 35 LAKE ELBERT DR., WINTER HAVEN, FL, 338803058, US | |||||||||||||||||||||||||
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| Phone | +1 863-299-0302 |
| Fax | 8632990370 |
Authorized person
| Name | MR. JERRY DANIELS |
| Role | OWNER |
| Phone | 8632990302 |
Taxonomy
| Taxonomy Code | 293D00000X - Physiological Laboratory |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE RAILROAD |
| Number | P00389765 |
| Issuer | BC FL |
| Number | V3161 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DANIELS JERRY W | Agent | 35 LAKE ELBERT DRIVE, WINTER HAVEN, FL, 33880 |
| Name | Role | Address |
|---|---|---|
| DANIELS JERRY W | Manager | 2049 SAN MARCOS DR.S.E. #224, WINTER HAVEN, FL, 33880 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-01-16 | 35 LAKE ELBERT DRIVE, WINTER HAVEN, FL 33880 | No data |
| CHANGE OF MAILING ADDRESS | 2012-01-16 | 35 LAKE ELBERT DRIVE, WINTER HAVEN, FL 33880 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-01-16 | DANIELS, JERRY W | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-01-16 | 35 LAKE ELBERT DRIVE, WINTER HAVEN, FL 33880 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-01-07 |
| ANNUAL REPORT | 2014-01-10 |
| ANNUAL REPORT | 2013-01-15 |
| ANNUAL REPORT | 2012-01-16 |
| ANNUAL REPORT | 2011-01-07 |
| ANNUAL REPORT | 2010-01-05 |
| ANNUAL REPORT | 2009-01-21 |
| ANNUAL REPORT | 2008-03-03 |
| ANNUAL REPORT | 2007-03-29 |
| ANNUAL REPORT | 2006-05-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
