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PADALA FAMILY PRACTICE, PLLC

Company Details

Entity Name: PADALA FAMILY PRACTICE, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 08 May 2012 (13 years ago)
Document Number: L12000062338
FEI/EIN Number 45-5239133
Address: 2021 N CROOKED BRANCH DR, LECANTO, FL 34461
Mail Address: 2021 N CROOKED BRANCH DR, LECANTO, FL 34461
ZIP code: 34461
County: Citrus
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1447505227 2012-07-18 2021-10-22 2063 N LECANTO HWY STE 1, LECANTO, FL, 344619675, US 2063 N LECANTO HWY STE 1, LECANTO, FL, 344619675, US

Contacts

Phone +1 352-436-4428
Fax 3522284903

Authorized person

Name LAKSHMI NARAYANA PADALA
Role OWNER
Phone 3524364428

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

Other Provider Identifiers

Issuer BCBS
Number 14L2T
State FL

Agent

Name Role Address
PADALA, LAKSHMI Agent 2021 N CROOKED BR DR, LECANTO, FL 34461

Managing Member

Name Role Address
PADALA, LAKSHMI N Managing Member 3587 N GRAYHAWK LOOP, LECANTO, FL 34461

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2015-04-23 PADALA, LAKSHMI No data
REGISTERED AGENT ADDRESS CHANGED 2015-04-23 2021 N CROOKED BR DR, LECANTO, FL 34461 No data
CHANGE OF PRINCIPAL ADDRESS 2014-04-16 2021 N CROOKED BRANCH DR, LECANTO, FL 34461 No data
CHANGE OF MAILING ADDRESS 2014-04-16 2021 N CROOKED BRANCH DR, LECANTO, FL 34461 No data

Documents

Name Date
ANNUAL REPORT 2024-04-26
ANNUAL REPORT 2023-04-26
ANNUAL REPORT 2022-04-22
ANNUAL REPORT 2021-04-26
ANNUAL REPORT 2020-05-27
ANNUAL REPORT 2019-04-25
ANNUAL REPORT 2018-05-01
ANNUAL REPORT 2017-04-27
ANNUAL REPORT 2016-04-17
ANNUAL REPORT 2015-04-23

Date of last update: 23 Jan 2025

Sources: Florida Department of State