| Entity Name: | MID-FLORIDA CRITICAL CARE PHYSICIAN SERVICES, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 21 May 2008 (17 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | L08000050623 |
| FEI/EIN Number | 421765832 |
| Address: | 200 AVE F NORTHWEST, WINTER HAVEN, FL, 33881 |
| Mail Address: | 200 AVE F NORTHWEST, WINTER HAVEN, FL, 33881 |
| ZIP code: | 33881 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356502108 | 2008-06-24 | 2008-12-10 | 134 ARIANA AVE, AUBURNDALE, FL, 338233319, US | 200 AVENUE F NE, WINTER HAVEN, FL, 338814131, US | |||||||||||||||||
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| Phone | +1 863-293-1121 |
| Fax | 8639680653 |
| Fax | 8632971867 |
Authorized person
| Name | DAVE MACDOUGALL |
| Role | CFO |
| Phone | 8632931121 |
Taxonomy
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ANASTASIO LANCE W | Agent | 200 AVE F NORTHWEST, WINTER HAVEN, FL, 33881 |
| Name | Role | Address |
|---|---|---|
| ANASTASIO LANCE W | Manager | 200 AVE F NORTHEAST, WINTER HAVEN, FL, 33881 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-05-01 |
| ANNUAL REPORT | 2010-04-30 |
| ANNUAL REPORT | 2009-04-23 |
| Florida Limited Liability | 2008-05-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
