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LAKE WALES EMERGENCY PHYSICIANS, LLC - Florida Company Profile

Company Details

Entity Name: LAKE WALES EMERGENCY PHYSICIANS, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

LAKE WALES EMERGENCY PHYSICIANS, 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: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 12 Jan 2012 (13 years ago)
Document Number: L12000006095
FEI/EIN Number 45-4250237

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

Address: 200 CORPORATE BLVD, LAFAYETTE, LA, 70508, US
Mail Address: 200 Corporate Blvd, Lafayette, LA, 70508, US
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1033480405 2012-01-18 2022-03-23 200 CORPORATE BLVD, LAFAYETTE, LA, 705083870, US 410 S 11TH ST, LAKE WALES, FL, 338534203, US

Contacts

Phone +1 800-893-9698
Phone +1 877-693-5700

Authorized person

Name LISHA C FALK
Role PRESIDENT
Phone 3376091221

Taxonomy

Taxonomy Code 207P00000X - Emergency Medicine Physician
Is Primary Yes
Taxonomy Code 363A00000X - Physician Assistant
Is Primary No
Taxonomy Code 363L00000X - Nurse Practitioner
Is Primary No

Other Provider Identifiers

Issuer MEDICAID
Number 004700800
State FL

Key Officers & Management

Name Role Address
EDCARE MANAGEMENT, INC. Manager -
CT CORPORATION SYSTEM Agent 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-03-07 200 CORPORATE BLVD, LAFAYETTE, LA 70508 -
CHANGE OF MAILING ADDRESS 2023-03-07 200 CORPORATE BLVD, LAFAYETTE, LA 70508 -

Documents

Name Date
ANNUAL REPORT 2024-04-08
ANNUAL REPORT 2023-03-07
ANNUAL REPORT 2022-03-17
ANNUAL REPORT 2021-02-05
ANNUAL REPORT 2020-02-07
ANNUAL REPORT 2019-04-12
ANNUAL REPORT 2018-03-06
ANNUAL REPORT 2017-03-22
ANNUAL REPORT 2016-04-05
ANNUAL REPORT 2015-04-23

Date of last update: 02 Mar 2025

Sources: Florida Department of State