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PARK LAKE PHYSICAL MEDICINE, LLC - Florida Company Profile

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Company Details

Entity Name: PARK LAKE PHYSICAL MEDICINE, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

PARK LAKE PHYSICAL MEDICINE, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 22 Nov 2011 (14 years ago)
Date of dissolution: 13 Dec 2019 (6 years ago)
Last Event: CORPORATE MERGER
Event Date Filed: 13 Dec 2019 (6 years ago)
Document Number: L11000132976
FEI/EIN Number 453861970

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 2206 EAST COLONIAL DR., ORLANDO, FL, 32803, US
Mail Address: 2206 EAST COLONIAL DR., ORLANDO, FL, 32803, US
ZIP code: 32803
County: Orange
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
INTEGRATIVE PHYSICAL MEDICINE HOLDING, LLC Manager 425 ALEXANDRIA BLVD, OVIEDO, FL, 32765
KABA CONSULTING INC. Agent -

National Provider Identifier

NPI Number:
1669749396

Authorized Person:

Name:
MRS. SHELBY ANNE REID
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Fax:
4078391044

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000076435 COMPLETE CARE EXPIRED 2019-07-15 2024-12-31 - 2206 EAST COLONIAL DR., ORLANDO, FL, 32803
G18000083169 INTEGRATIVE PHYSICAL MEDICINE EXPIRED 2018-08-01 2023-12-31 - 2206 E COLONIAL DR, ORLANDO, FL, 32806
G14000052446 COLTEN HEALTHCARE MANAGEMENT EXPIRED 2014-05-30 2019-12-31 - 2206 EAST COLONIAL DR., ORLANDO, FL, 32803
G12000011595 INTEGRATIVE PHYSICAL MEDICINE EXPIRED 2012-02-02 2017-12-31 - 300 EAST COLONIAL DRIVE, ORLANDO, FL, 32801

Events

Event Type Filed Date Value Description
MERGER 2019-12-13 - CORPORATION WAS PART OF A MERGER. QUALIFIED CORPORATION WAS L12000112955. MERGER NUMBER 100000198291
LC AMENDMENT 2016-04-14 - -
CHANGE OF PRINCIPAL ADDRESS 2013-05-08 2206 EAST COLONIAL DR., ORLANDO, FL 32803 -
CHANGE OF MAILING ADDRESS 2013-05-08 2206 EAST COLONIAL DR., ORLANDO, FL 32803 -
REGISTERED AGENT NAME CHANGED 2013-04-11 KABA CONSULTING INC -
REGISTERED AGENT ADDRESS CHANGED 2013-04-11 1655 E HWY 50, SUITE 203, CLERMONT, FL 34711 -

Documents

Name Date
ANNUAL REPORT 2019-04-18
ANNUAL REPORT 2018-04-16
ANNUAL REPORT 2017-03-15
LC Amendment 2016-04-14
ANNUAL REPORT 2016-02-24
ANNUAL REPORT 2015-03-20
ANNUAL REPORT 2014-04-25
ANNUAL REPORT 2013-04-11
ANNUAL REPORT 2012-04-23
Florida Limited Liability 2011-11-22

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Date of last update: 02 Jul 2025

Sources: Florida Department of State