| Entity Name: | LEHIGH PERSONAL INJURY CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 02 Jan 2019 (6 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: | L19000004802 |
| Address: | 60 Westminster St North, lehigh acres, FL, 33936, UN |
| Mail Address: | 60 Westminster St North, lehigh acres, FL, 33936, UN |
| ZIP code: | 33936 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255988929 | 2019-08-19 | 2019-08-19 | 9858 CLINT MOORE RD # C111-274, BOCA RATON, FL, 334961034, US | 60 WESTMINSTER ST N, LEHIGH ACRES, FL, 339366518, US | |||||||||||||||||
|
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| Phone | +1 561-482-1144 |
| Fax | 5614821145 |
| Phone | +1 813-476-9734 |
Authorized person
| Name | MARCY MIELZ |
| Role | BILLING MANAGER |
| Phone | 5614821144 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BLOOM JACY G | Agent | 60 WESTMINISTER ST N, LEIGH ACRES, FL, 33936 |
| Name | Role | Address |
|---|---|---|
| BLOOM JACY G | Manager | 2255 Proctor RD, Sarasota, FL, 34231 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000062175 | LEHIGH SPINE AND INJURY CENTER | EXPIRED | 2019-05-28 | 2024-12-31 | No data | 12030 FAIRWAY ISLE DRIVE, FORT MYERS, FL, 33913 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-03-09 | BLOOM, JACY G | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-09 | 60 WESTMINISTER ST N, LEIGH ACRES, FL 33936 | No data |
| LC AMENDMENT | 2020-03-09 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-02-18 | 60 Westminster St North, lehigh acres, FL 33936 UN | No data |
| CHANGE OF MAILING ADDRESS | 2020-02-18 | 60 Westminster St North, lehigh acres, FL 33936 UN | No data |
| LC AMENDMENT | 2019-12-30 | No data | No data |
| LC AMENDMENT | 2019-09-16 | No data | No data |
| Name | Date |
|---|---|
| LC Amendment | 2020-03-09 |
| ANNUAL REPORT | 2020-01-22 |
| LC Amendment | 2019-12-30 |
| LC Amendment | 2019-09-16 |
| Florida Limited Liability | 2019-01-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
