| Entity Name: | ISPM OF FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 Oct 2010 (14 years ago) |
| Date of dissolution: | 15 Nov 2013 (11 years ago) |
| Last Event: | LC VOLUNTARY DISSOLUTION |
| Event Date Filed: | 15 Nov 2013 (11 years ago) |
| Document Number: | L10000109203 |
| FEI/EIN Number | 272386799 |
| Address: | 5410 E. CO. HWY 30A, SUITE 213, SEAGROVE BEACH, FL, 32459, US |
| Mail Address: | 5410 E. CO. HWY 30A, SUITE 213, SEAGROVE BEACH, FL, 32459, US |
| ZIP code: | 32459 |
| County: | Walton |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023335296 | 2010-04-28 | 2012-08-24 | 3400 PEACHTREE RD NE, STE 811, ATLANTA, GA, 303261107, US | 610 EAST OLYMPIA BLVD, STE 202, PUNTA GORDA, FL, 339503875, US | |||||||||||||||||||
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| Phone | +1 941-205-0270 |
| Fax | 9412050276 |
| Phone | +1 941-833-1100 |
| Fax | 9416370437 |
Authorized person
| Name | MISS SAMANTHA A CRANDALL |
| Role | ADMINISTRATOR |
| Phone | 9412050270 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FOWLER ROBIN J | Agent | 22 SEVEN WELLS COURT, ALYS BEACH, FL, 32461 |
| Name | Role | Address |
|---|---|---|
| FOWLER ROBIN J | Manager | 281 WEST PACES FERRY RD NW, ATLANTA, GA, 30305 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC VOLUNTARY DISSOLUTION | 2013-11-15 | No data | No data |
| LC AMENDMENT | 2013-08-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-08-23 | 5410 E. CO. HWY 30A, SUITE 213, SEAGROVE BEACH, FL 32459 | No data |
| CHANGE OF MAILING ADDRESS | 2013-08-23 | 5410 E. CO. HWY 30A, SUITE 213, SEAGROVE BEACH, FL 32459 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-08-23 | FOWLER, ROBIN J | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-08-23 | 22 SEVEN WELLS COURT, ALYS BEACH, FL 32461 | No data |
| Name | Date |
|---|---|
| LC Voluntary Dissolution | 2013-11-15 |
| LC Amendment | 2013-08-23 |
| ANNUAL REPORT | 2013-02-04 |
| ANNUAL REPORT | 2012-02-07 |
| ANNUAL REPORT | 2011-01-07 |
| FEI | 2010-11-15 |
| Florida Limited Liability | 2010-10-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
