| Entity Name: | WITTENBORN PLASTIC SURGERY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 03 Apr 2008 (17 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L08000033933 |
| FEI/EIN Number | 262329682 |
| Address: | 14072 Shimmering Lake Ct, FT MYERS, FL, 33907, US |
| Mail Address: | 14072 Shimmering Lake Ct., Ft. Myers, FL, 33907, US |
| ZIP code: | 33907 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639333115 | 2008-07-15 | 2009-05-06 | 13300 S CLEVELAND AVE STE 56, #261, FORT MYERS, FL, 339073871, US | 14131 METROPOLIS AVE STE 105, FORT MYERS, FL, 339124332, US | |||||||||||||||||||||||||
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| Phone | +1 239-561-2313 |
| Fax | 8885002420 |
Authorized person
| Name | DR. WILLIAM SCOTT WITTENBORN |
| Role | OWNER |
| Phone | 2395612313 |
Taxonomy
| Taxonomy Code | 208200000X - Plastic Surgery Physician |
| License Number | 87881 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | 71645X |
| State | FL |
| Name | Role |
|---|---|
| WPW, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| WITTENBORN WILLIAM S | Manager | 14072 Shimmering Lake Ct., Ft. Myers, FL, 33907 |
| WITTENBORN ANNE M | Manager | 14072 Shimmering Lake Ct., Ft. Myers, FL, 33907 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-10-20 | 14072 Shimmering Lake Ct, FT MYERS, FL 33907 | No data |
| REINSTATEMENT | 2022-10-20 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-10-20 | 14072 Shimmering Lake Ct, FT MYERS, FL 33907 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-10-20 | WPW LLC | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-29 | 14072 Shimmering Lake Ct, FT MYERS, FL 33907 | No data |
| REINSTATEMENT | 2014-10-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J12000610082 | TERMINATED | 1000000343291 | LEE | 2012-09-04 | 2032-09-19 | $ 620.35 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| Name | Date |
|---|---|
| REINSTATEMENT | 2022-10-20 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-04-04 |
| ANNUAL REPORT | 2016-03-17 |
| ANNUAL REPORT | 2015-04-21 |
| REINSTATEMENT | 2014-10-01 |
| ANNUAL REPORT | 2013-04-24 |
| ANNUAL REPORT | 2012-04-10 |
| ANNUAL REPORT | 2011-04-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
