| Entity Name: | LEAVITT DERMATOPATHOLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 24 Aug 2006 (18 years ago) |
| Date of dissolution: | 28 May 2019 (6 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 28 May 2019 (6 years ago) |
| Document Number: | L06000083888 |
| FEI/EIN Number | 20-5431435 |
| Address: | 151 Southhall Lane, Suite 300, MAITLAND, FL 32751 |
| Mail Address: | 151 Southhall Lane, Suite 300, MAITLAND, FL 32751 |
| ZIP code: | 32751 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124331350 | 2010-07-16 | 2015-03-03 | 151 SOUTHHALL LN, SUITE 300, MAITLAND, FL, 327517176, US | 1300 NW 17TH AVE STE 130, DELRAY BEACH, FL, 334452588, US | |||||||||||||||||||
|
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| Phone | +1 407-875-2080 |
| Fax | 4078750518 |
| Phone | +1 561-819-0857 |
| Fax | 5615490173 |
Authorized person
| Name | AMY DECLUE |
| Role | DIRECTOR, PROVIDER SERVICES |
| Phone | 4078752080 |
Taxonomy
| Taxonomy Code | 207ND0900X - Dermatopathology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LEAVITT, MICHAEL | Agent | 151 Southhall Lane, Suite 300, MAITLAND, FL 32751 |
| Name | Role | Address |
|---|---|---|
| LEAVITT, MICHAEL | Managing Member | 151 Southhall Lane, Suite 300, MAITLAND, FL 32751 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2019-05-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-15 | 151 Southhall Lane, Suite 300, MAITLAND, FL 32751 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-15 | 151 Southhall Lane, Suite 300, MAITLAND, FL 32751 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-15 | 151 Southhall Lane, Suite 300, MAITLAND, FL 32751 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2019-05-28 |
| ANNUAL REPORT | 2018-03-30 |
| ANNUAL REPORT | 2017-04-17 |
| ANNUAL REPORT | 2016-04-21 |
| ANNUAL REPORT | 2015-04-23 |
| ANNUAL REPORT | 2014-04-22 |
| ANNUAL REPORT | 2013-04-15 |
| ANNUAL REPORT | 2012-04-16 |
| ANNUAL REPORT | 2011-04-19 |
| ANNUAL REPORT | 2010-04-05 |
Date of last update: 27 Jan 2025
Sources: Florida Department of State
