| Entity Name: | LIGHTHOUSE CENTER FOR SPEECH AND LANGUAGE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 20 Jun 2014 (11 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | L14000099010 |
| FEI/EIN Number | 47-1368546 |
| Address: | 2939 MAJESTIC ISLE DRIVE, CLERMONT, FL, 34711, US |
| Mail Address: | 2939 Majestic Isle Dr, Clermont, FL, 34711, US |
| ZIP code: | 34711 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598907024 | 2009-03-30 | 2014-08-12 | 11923 OTTAWA AVE, ORLANDO, FL, 328377736, US | 11923 OTTAWA AVE, ORLANDO, FL, 328377736, US | |||||||||||||||||||||||
|
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| Phone | +1 407-697-7482 |
Authorized person
| Name | SONIA E MALAVE |
| Role | SPEECH-LANGUAGE PATHOLOGIST |
| Phone | 4076977482 |
Taxonomy
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | SA 5057 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000974300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MALAVE SONIA E | Agent | 2939 Majestic Isle Dr, Clermont, FL, 34711 |
| Name | Role | Address |
|---|---|---|
| MALAVE SONIA E | Manager | 2939 Majestic Isle Dr, Clermont, FL, 34711 |
| MALAVE JOSEPH M | Manager | 2939 Majestic Isle Dr, Clermont, FL, 34711 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2017-04-28 | 2939 MAJESTIC ISLE DRIVE, CLERMONT, FL 34711 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-28 | 2939 Majestic Isle Dr, Clermont, FL 34711 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-09-28 | 2939 MAJESTIC ISLE DRIVE, CLERMONT, FL 34711 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-06-12 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-29 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-30 |
| ANNUAL REPORT | 2015-04-30 |
| Florida Limited Liability | 2014-06-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
