| Entity Name: | KWABENA AMPONSAH PA-C, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 02 May 2011 (14 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L11000051412 |
| FEI/EIN Number | 452126316 |
| Address: | 10018 Madison Banks Street, Orlando, FL, 32827, US |
| Mail Address: | 10018 Madison Banks Street, Orlando, FL, 32827, US |
| ZIP code: | 32827 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184916801 | 2011-05-12 | 2020-12-03 | 10524 MOSS PARK RD STE 204-771, ORLANDO, FL, 328325898, US | 10524 MOSS PARK RD STE 204-771, ORLANDO, FL, 328325898, US | |||||||||||||||||||||||||
|
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| Phone | +1 937-902-2068 |
Authorized person
| Name | MR. KWABENA AMPONSAH |
| Role | PRESIDENT/CEO |
| Phone | 9379022068 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ME99974 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363A00000X - Physician Assistant |
| License Number | PA9104033 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| AMPONSAH KWABENA | Agent | 10018 Madison Banks Street, Orlando, FL, 32827 |
| Name | Role | Address |
|---|---|---|
| AMPONSAH KWABENA | Managing Member | 10018 Madison Banks Street, Orlando, FL, 32827 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000032463 | MKA SURGICAL GROUP | EXPIRED | 2013-04-04 | 2024-12-31 | No data | 10524 MOSS PARK ROAD, SUITE 204-771, ORLANDO, FL, 32832 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-16 | 10018 Madison Banks Street, Orlando, FL 32827 | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-16 | 10018 Madison Banks Street, Orlando, FL 32827 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-16 | 10018 Madison Banks Street, Orlando, FL 32827 | No data |
| LC AMENDMENT AND NAME CHANGE | 2012-04-05 | KWABENA AMPONSAH PA-C, PLLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-29 |
| ANNUAL REPORT | 2016-02-09 |
| ANNUAL REPORT | 2015-04-16 |
| ANNUAL REPORT | 2014-04-15 |
| ANNUAL REPORT | 2013-03-24 |
| LC Amendment and Name Change | 2012-04-05 |
| ANNUAL REPORT | 2012-03-02 |
| Florida Limited Liability | 2011-05-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
