| Entity Name: | EXPRESS CARE OF LAKE COUNTY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 01 Aug 2014 (10 years ago) |
| Date of dissolution: | 09 Jan 2017 (8 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 09 Jan 2017 (8 years ago) |
| Document Number: | L14000120989 |
| FEI/EIN Number | 35-2513578 |
| Address: | 2020 NIGHTINGALE LANE, TAVARES, FL 32778 |
| Mail Address: | 2020 NIGHTINGALE LANE, TAVARES, FL 32778 |
| ZIP code: | 32778 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215338025 | 2014-09-11 | 2016-11-15 | 2020 NIGHTINGALE LN, TAVARES, FL, 327784361, US | 2020 NIGHTINGALE LN, TAVARES, FL, 327784361, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 352-742-1500 |
| Fax | 3527422530 |
Authorized person
| Name | KIMBERLY T JACKSON |
| Role | MEDICAL DIRECTOR |
| Phone | 3527421500 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS11411 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CANNON, JEFFREY G | Agent | 2106 N ORANGE AVE, STE 100, ORLANDO, FL 32804 |
| Name | Role | Address |
|---|---|---|
| CANNON, JEFFREY G | Manager | 2106 N ORANGE AVE STE 100, ORLANDO, FL 32804 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2017-01-09 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-03-14 |
| ANNUAL REPORT | 2015-05-01 |
| Florida Limited Liability | 2014-08-01 |
Date of last update: 21 Jan 2025
Sources: Florida Department of State
