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