| Entity Name: | CLASSIC CARE OF FLORIDA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 17 Dec 2010 (14 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: | L10000129203 |
| FEI/EIN Number | 274393457 |
| Address: | 1504 South Street, LEESBURG, FL, 34748, US |
| Mail Address: | 1504 SOUTH STREET, LEESBURG, FL, 34748, US |
| ZIP code: | 34748 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629329313 | 2012-09-21 | 2013-08-02 | 1504 SOUTH ST, LEESBURG, FL, 347486630, US | 1504 SOUTH ST, LEESBURG, FL, 347486630, US | |||||||||||||||||||||||
|
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| Phone | +1 352-314-1885 |
| Fax | 3523141890 |
Authorized person
| Name | MS. JUNE K LEW |
| Role | CEO |
| Phone | 3523141885 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299991659 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PROVIDER NUMBER |
| Number | 107786 |
| Name | Role | Address |
|---|---|---|
| Talwar Sunil | Agent | 1891 Lakeshore Drive, Mt. Dora, FL, 32757 |
| Name | Role | Address |
|---|---|---|
| LEW JUNE | Manager | 917 S 14TH ST, LEESBURG, FL, 34748 |
| VICK JOHN CIII | Manager | 496 S. HUNT CLUB BLVD, APOPKA, FL, 32703 |
| Name | Role | Address |
|---|---|---|
| TALWAR SUNIL | Vice Operating Manager | 917 S 14TH ST, LEESBURG, FL, 34748 |
| Name | Role | Address |
|---|---|---|
| LEW JUNE | Secretary | 917 S 14TH ST, LEESBURG, FL, 34748 |
| Name | Role | Address |
|---|---|---|
| TALWAR SUNIL | Treasurer | 917 S 14TH ST, LEESBURG, FL, 34748 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000003178 | CLASSIC HOME HEALTH SERVICES | EXPIRED | 2013-01-09 | 2018-12-31 | No data | 1504 SOUTH ST, LEESBURG, FL, 34748 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| LC AMENDMENT | 2022-08-17 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-29 | 1504 South Street, LEESBURG, FL 34748 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-03-11 | Talwar, Sunil | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-03-11 | 1891 Lakeshore Drive, Mt. Dora, FL 32757 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-01-31 | 1504 South Street, LEESBURG, FL 34748 | No data |
| Name | Date |
|---|---|
| LC Amendment | 2022-08-17 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-01 |
| ANNUAL REPORT | 2020-02-10 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-02-17 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-03-11 |
| ANNUAL REPORT | 2014-03-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
