| Entity Name: | LAKE WALES UROLOGY,LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 16 Sep 2013 (11 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | L13000130605 |
| FEI/EIN Number | 46-3662463 |
| Address: | 1110 DRUID CIRCLE, STE B, LAKE WALES, FL, 33853, US |
| Mail Address: | 1110 DRUID CIRCLE, STE B, LAKE WALES, FL, 33853, US |
| ZIP code: | 33853 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063849248 | 2013-10-02 | 2013-10-04 | 1110 DRUID CIR, LAKE WALES, FL, 338534307, US | 1110 DRUID CIR, LAKE WALES, FL, 338534307, US | |||||||||||||||||||
|
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| Phone | +1 863-877-2411 |
| Fax | 8638772377 |
Authorized person
| Name | MATTHEW WILLIAM LOUGHLIN |
| Role | PRESIDENT |
| Phone | 8638772411 |
Taxonomy
| Taxonomy Code | 208800000X - Urology Physician |
| License Number | ME87080 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LOUGHLIN MATTHEW W | Agent | 1110 DRUID CIRCLE, LAKE WALES, FL, 33853 |
| Name | Role | Address |
|---|---|---|
| LOUGHLIN MATTHEW W | Managing Member | 1110 DRUID CIRCLE, STE B, LAKE WALES, FL, 33853 |
| Name | Role | Address |
|---|---|---|
| Allam Mahesh MGR | Manager | 1110 DRUID CIRCLE, LAKE WALES, FL, 33853 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-06-11 |
| Florida Limited Liability | 2013-09-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
