| Entity Name: | MARK A LAMBERT LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Feb 2019 (6 years ago) |
| Document Number: | L19000035386 |
| FEI/EIN Number | 83-3548476 |
| Address: | 1133 W KING ST, ST AUGUSTINE, FL, 32084, US |
| Mail Address: | 1133 W KING ST, ST AUGUSTINE, FL, 32084, US |
| ZIP code: | 32084 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598954968 | 2007-10-22 | 2019-06-28 | 4850 N 9TH AVE, PENSACOLA, FL, 325032407, US | 4850 N 9TH AVE, PENSACOLA, FL, 325032407, US | |||||||||||||||||||||||||
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| Phone | +1 850-477-9015 |
| Fax | 8504785227 |
Authorized person
| Name | DR. MARK A LAMBERT |
| Role | OWNER |
| Phone | 8504779015 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| License Number | PO2803 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS OF FLORIDA |
| Number | 38932 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LAMBERT MARK A | Agent | 1180 MORGANS TREASURE RD, SAINT AUGUSTINE, FL, 32084 |
| Name | Role | Address |
|---|---|---|
| LAMBERT DARLENE L | Vice President | 1133 W KING ST, ST AUGUSTINE, FL, 32084 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000022046 | KARR DOCTOR | EXPIRED | 2019-02-13 | 2024-12-31 | No data | 1133 WEST KINGS STREET, ST. AUGUSTINE, FL, 32084 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-05 | 1180 MORGANS TREASURE RD, SAINT AUGUSTINE, FL 32084 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-04-06 |
| AMENDED ANNUAL REPORT | 2021-04-24 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-06 |
| Florida Limited Liability | 2019-02-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
