| Entity Name: | LAKELAND MEDICAL MASSAGE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 29 Dec 2017 (7 years ago) |
| Document Number: | L17000264614 |
| FEI/EIN Number | 82-3872785 |
| Mail Address: | 1555 WILLIAMSBURG SQUARE, LAKELAND, FL 33803 |
| Address: | 335 DORIS DR, LAKELAND, FL 33813 |
| ZIP code: | 33813 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851898613 | 2018-04-09 | 2023-02-06 | 335 DORIS DR, LAKELAND, FL, 338131008, US | 335 DORIS DR, LAKELAND, FL, 338131008, US | |||||||||||||||||
|
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| Phone | +1 863-695-2246 |
Authorized person
| Name | CHRISTOPHER STINNETT |
| Role | CEO |
| Phone | 8635009458 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | MM37858 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| STINNETT, TY CHRISTOPHER | Agent | 1555 WILLIAMSBURG SQUARE, LAKELAND, FL 33803 |
| Name | Role | Address |
|---|---|---|
| STINNETT, CHRISTOPHER Z | Chief Executive Officer | 335 DORIS DR, LAKELAND, FL 33813 |
| Name | Role | Address |
|---|---|---|
| Mai Ngam, Kesara | CHIEF MEDICAL OFFICER | 335 DORIS DR, LAKELAND, FL 33813 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-20 | 335 DORIS DR, LAKELAND, FL 33813 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-20 | 335 DORIS DR, LAKELAND, FL 33813 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-01-20 | STINNETT, TY CHRISTOPHER | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-20 | 1555 WILLIAMSBURG SQUARE, LAKELAND, FL 33803 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-22 |
| ANNUAL REPORT | 2023-01-20 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-01-07 |
| ANNUAL REPORT | 2020-01-12 |
| ANNUAL REPORT | 2019-02-11 |
| Florida Limited Liability | 2017-12-29 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
