| Entity Name: | FLORIDA LAKES SURGICAL, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
FLORIDA LAKES SURGICAL, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 08 May 2007 (18 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 29 Sep 2009 (16 years ago) |
| Document Number: | L07000049156 |
| FEI/EIN Number |
208995750
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4759 LAKEVIEW DRIVE, SEBRING, FL, 33870, US |
| Mail Address: | 4759 LAKEVIEW DRIVE, SEBRING, FL, 33870, US |
| ZIP code: | 33870 |
| County: | Highlands |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174727937 | 2007-06-13 | 2015-05-11 | 4751 LAKEVIEW DR, SEBRING, FL, 338702064, US | 4751 LAKEVIEW DR, SEBRING, FL, 338702064, US | |||||||||||||||||||||
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| Phone | +1 863-402-5600 |
| Fax | 8634025602 |
Authorized person
| Name | DR. THOMAS C LACKEY II |
| Role | OWNER |
| Phone | 86340265600 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 279537000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LACKEY THOMAS CII | Manager | 4759 LAKEVIEW DRIVE, SEBRING, FL, 33870 |
| LACKEY THOMAS C | Agent | 4759 LAKEVIEW DRIVE, SEBRING, FL, 33870 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000001735 | YOUR HEALTH | ACTIVE | 2015-01-06 | 2025-12-31 | - | 4751 LAKEVIEW DRIVE, SEBRING, FL, 33870 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-03-27 | 4759 LAKEVIEW DRIVE, SEBRING, FL 33870 | - |
| CHANGE OF MAILING ADDRESS | 2017-03-27 | 4759 LAKEVIEW DRIVE, SEBRING, FL 33870 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2017-03-27 | 4759 LAKEVIEW DRIVE, SEBRING, FL 33870 | - |
| CANCEL ADM DISS/REV | 2009-09-29 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | - | - |
| REGISTERED AGENT NAME CHANGED | 2008-01-14 | LACKEY, THOMAS CII | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-29 |
| ANNUAL REPORT | 2021-01-18 |
| ANNUAL REPORT | 2020-07-01 |
| ANNUAL REPORT | 2019-06-13 |
| ANNUAL REPORT | 2018-06-27 |
| ANNUAL REPORT | 2017-03-27 |
| ANNUAL REPORT | 2016-03-26 |
| ANNUAL REPORT | 2015-01-07 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6212858607 | 2021-03-20 | 0455 | PPS | 4759 Lakeview Dr Ste 101, Sebring, FL, 33870-2005 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5722967702 | 2020-05-01 | 0455 | PPP | SUITE 101 4759 LAKEVIEW DR STE 101, SEBRING, FL, 33870-2005 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
