| Entity Name: | UC1 LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 03 Nov 2011 (13 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: | L11000125475 |
| FEI/EIN Number | 455108249 |
| Address: | 799 W LUMSDEN ROAD, BRANDON, FL, 33511 |
| Mail Address: | 799 W LUMSDEN ROAD, BRANDON, FL, 33511 |
| ZIP code: | 33511 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265780910 | 2012-08-28 | 2013-05-17 | 611 W AZEELE ST, TAMPA, FL, 336062205, US | 799 LUMSDEN RD, BRANDON, FL, 33511, US | |||||||||||||||||||||||||
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| Phone | +1 813-684-1199 |
| Fax | 8134642733 |
Authorized person
| Name | JAMES M LOWRANCE |
| Role | ADMINISTRATOR |
| Phone | 8136841199 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 006639500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DOMINGUEZ TINA | Agent | 799 W LUMSDEN ROAD, BRANDON, FL, 33511 |
| Name | Role | Address |
|---|---|---|
| HALPERN DAVID MD | Manager | 799 W LUMSDEN ROAD, BRANDON, FL, 33511 |
| DOMINGUEZ JOSE CMD | Manager | 799 W LUMSDEN ROAD, BRANDON, FL, 33511 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000082324 | 1ST CARE MEDICAL | EXPIRED | 2012-08-20 | 2017-12-31 | No data | 611 W AZEELE, TAMPA, FL, 33606 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| LC AMENDMENT | 2014-10-08 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-10-08 | 799 W LUMSDEN ROAD, BRANDON, FL 33511 | No data |
| CHANGE OF MAILING ADDRESS | 2014-10-08 | 799 W LUMSDEN ROAD, BRANDON, FL 33511 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-10-08 | DOMINGUEZ, TINA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-10-08 | 799 W LUMSDEN ROAD, BRANDON, FL 33511 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-28 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-04-30 |
| LC Amendment | 2014-10-08 |
| ANNUAL REPORT | 2014-04-22 |
| ANNUAL REPORT | 2013-04-06 |
| ANNUAL REPORT | 2012-04-30 |
| Florida Limited Liability | 2011-11-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
