| Entity Name: | LIFE MEDICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
LIFE MEDICAL GROUP, 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: |
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: | 18 Feb 2013 (12 years ago) |
| Date of dissolution: | 27 Sep 2019 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (6 years ago) |
| Document Number: | L13000024874 |
| FEI/EIN Number |
462425200
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 14614 LIVINGSTON AVE, LUTZ, FL, 33559 |
| Mail Address: | 14614 Livingston Ave, Lutz, FL, 33559, US |
| ZIP code: | 33559 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922441054 | 2013-04-08 | 2016-03-06 | 14614 LIVINGSTON AVE, LUTZ, FL, 335593101, US | 14614 LIVINGSTON AVE, LUTZ, FL, 335593101, US | |||||||||||||||||||||||||
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| Phone | +1 813-972-7979 |
| Fax | 8139722424 |
Authorized person
| Name | DR. ADRIANNE MARIA RIDLEY-PAYNE |
| Role | OWNER |
| Phone | 8139727979 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ME82833 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CAQH |
| Number | 12523258 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RIDLEY-PAYNE ADRIANNE M | President | 7632 DUNBRIDGE DR, ODESSA, FL, 33556 |
| PAYNE THOMAS J | Chief Executive Officer | 7632 DUNBRIDGE DR, ODESSA, FL, 33556 |
| PAYNE THOMAS J | Agent | 7632 DUNBRIDGE DR, ODESSA, FL, 33556 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | - | - |
| CHANGE OF MAILING ADDRESS | 2015-04-30 | 14614 LIVINGSTON AVE, LUTZ, FL 33559 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-03 | 14614 LIVINGSTON AVE, LUTZ, FL 33559 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-04-30 |
| ANNUAL REPORT | 2015-04-30 |
| ANNUAL REPORT | 2014-04-30 |
| Florida Limited Liability | 2013-02-18 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
