| Entity Name: | EAST LAKE MEDICAL CLINIC, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
EAST LAKE MEDICAL CLINIC, PLLC 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: | 12 Apr 2013 (12 years ago) |
| Date of dissolution: | 02 Mar 2016 (9 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 02 Mar 2016 (9 years ago) |
| Document Number: | L13000053766 |
| FEI/EIN Number |
46-2478545
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4737 OLD CANOE CREEK ROAD, ST. CLOUD, FL, 34769 |
| Mail Address: | 4737 old canoe creek rd, ST. CLOUD, FL, 34769, US |
| ZIP code: | 34769 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790124741 | 2013-06-21 | 2013-06-21 | 4737 OLD CANOE CREEK RD, SAINT CLOUD, FL, 347691400, US | 4737 OLD CANOE CREEK RD, SAINT CLOUD, FL, 347691400, US | |||||||||||||||||
|
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| Phone | +1 407-705-3222 |
Authorized person
| Name | DR. DUSTIN LY |
| Role | PRESIDENT |
| Phone | 4077053222 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME114777 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LY KATE N | Manager | 4737 OLD CANOE CREEK RD, ST. CLOUD, FL, 34769 |
| LY DUSTIN N | Managing Member | 4737 OLD CANOE CREEK RD, ST. CLOUD, FL, 34769 |
| LY KATE N | Agent | 4737 old canoe creek rd, ST. CLOUD, FL, 34769 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2016-03-02 | - | CONVERSION MEMBER. RESULTING CORPORATION WAS P16000021885. CONVERSION NUMBER 100000158991 |
| CHANGE OF MAILING ADDRESS | 2014-01-09 | 4737 OLD CANOE CREEK ROAD, ST. CLOUD, FL 34769 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-09 | 4737 old canoe creek rd, ST. CLOUD, FL 34769 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-01-27 |
| ANNUAL REPORT | 2015-01-07 |
| ANNUAL REPORT | 2014-01-09 |
| Florida Limited Liability | 2013-04-12 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
