| Entity Name: | W. SAND LAKE MEDICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
W. SAND LAKE 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: | 01 Oct 2015 (10 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: | L15000167675 |
| FEI/EIN Number |
47-5334432
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 2328 10TH AVE N STE 301, LAKE WORTH, FL, 33461 |
| Mail Address: | 2328 10TH AVE N STE 301, LAKE WORTH, FL, 33461 |
| ZIP code: | 33461 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558726257 | 2015-12-22 | 2015-12-22 | 2328 10TH AVE N STE 302, LAKE WORTH, FL, 334616612, US | 2431 SAND LAKE RD, ORLANDO, FL, 328097641, US | |||||||||||||
|
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| Phone | +1 855-876-8648 |
Authorized person
| Name | NICK MATTEO |
| Role | CFO |
| Phone | 5613184430 |
Taxonomy
| Taxonomy Code | 207RA0401X - Addiction Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DORAN TIMOTHY | Manager | 2328 10TH AVE N, LAKE WORTH, FL, 33461 |
| CHIEFFALLO CARA | Agent | NASON YEAGER ETAL, PALM BEACH GARDENS, FL, 33410 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-10-01 | 2328 10TH AVE N STE 301, LAKE WORTH, FL 33461 | - |
| CHANGE OF MAILING ADDRESS | 2025-10-01 | 2328 10TH AVE N STE 301, LAKE WORTH, FL 33461 | - |
| CHANGE OF MAILING ADDRESS | 2024-10-01 | 2328 10TH AVE N STE 301, LAKE WORTH, FL 33461 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-01 | 2328 10TH AVE N STE 301, LAKE WORTH, FL 33461 | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | - | - |
| REGISTERED AGENT NAME CHANGED | 2018-03-09 | CHIEFFALLO, CARA | - |
| REGISTERED AGENT ADDRESS CHANGED | 2018-03-09 | NASON YEAGER ETAL, 3001 PGA BLVD., #305, PALM BEACH GARDENS, FL 33410 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-01-27 |
| ANNUAL REPORT | 2016-03-29 |
| Florida Limited Liability | 2015-10-01 |
Date of last update: 02 May 2025
Sources: Florida Department of State
