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 |
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 | |||||||||||||||||||||
|
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 |
Name | Role | Address |
---|---|---|
PADALA, LAKSHMI | Agent | 2021 N CROOKED BR DR, LECANTO, FL 34461 |
Name | Role | Address |
---|---|---|
PADALA, LAKSHMI N | Managing Member | 3587 N GRAYHAWK LOOP, LECANTO, FL 34461 |
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 |
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