| Entity Name: | HENSLEY MEDICAL GROUP, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 16 Jun 2017 (8 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L17000132192 |
| FEI/EIN Number | 82-1888462 |
| Address: | 26907 Foggy Creek Rd, ste 102, Wesley Chapel, FL 33544 |
| Mail Address: | 26907 Foggy Creek Rd, ste 102, Wesley Chapel, FL 33544 |
| ZIP code: | 33544 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043731904 | 2017-06-30 | 2017-12-13 | 26907 FOGGY CREEK RD STE 102, WESLEY CHAPEL, FL, 335446778, US | 26907 FOGGY CREEK RD STE 102, WESLEY CHAPEL, FL, 335446778, US | |||||||||||||||||||
|
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| Phone | +1 813-501-4468 |
| Fax | 8135018620 |
Authorized person
| Name | LOREN HENSLEY |
| Role | MGR |
| Phone | 8135014468 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | OS12462 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DE LA PARTE & GILBERT, P.A. | Agent | 101 E. KENNEDY BOULEVARD, SUITE 2000, TAMPA, FL 33602 |
| Name | Role | Address |
|---|---|---|
| HENSLEY, LOREN, D.O. | Manager | 8704 WINSOME WAY, LAND O'LAKES, FL 34637 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-01-30 | 26907 Foggy Creek Rd, ste 102, Wesley Chapel, FL 33544 | No data |
| CHANGE OF MAILING ADDRESS | 2018-01-30 | 26907 Foggy Creek Rd, ste 102, Wesley Chapel, FL 33544 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-01-30 |
| Florida Limited Liability | 2017-06-16 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
