| Entity Name: | SWAN ORAL & FACIAL SURGERY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 16 Sep 2019 (5 years ago) |
| Date of dissolution: | 02 Feb 2024 (a year ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 02 Feb 2024 (a year ago) |
| Document Number: | L19000233050 |
| FEI/EIN Number | 84-3675995 |
| Address: | 407 S KENTUCKY AVE, LAKELAND, FL 33801 |
| Mail Address: | 2611 SE 17TH ST, SUITE A, OCALA, FL 34471 |
| ZIP code: | 33801 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073143731 | 2020-01-22 | 2020-01-22 | 407 S KENTUCKY AVE, LAKELAND, FL, 338015301, US | 407 S KENTUCKY AVE, LAKELAND, FL, 338015301, US | |||||||||||||||||||||
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| Phone | +1 863-688-1537 |
| Fax | 8636873418 |
Authorized person
| Name | RUSHI PATEL |
| Role | OWNER |
| Phone | 8636881537 |
Taxonomy
| Taxonomy Code | 261QS0112X - Oral and Maxillofacial Surgery Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE LICENSE |
| Number | DN17708 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PATEL, RUSHI S | Agent | 2611 SE 17TH ST, SUITE A, OCALA, FL 34471 |
| Name | Role | Address |
|---|---|---|
| PATEL, RUSHI S | Manager | 2611 SE 17TH ST SUITE A, OCALA, FL 34471 |
| BEDI, MANIK S | Manager | 2611 SE 17TH ST SUITE A, OCALA, FL 34471 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-02-02 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-02-02 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-30 |
| ANNUAL REPORT | 2020-01-20 |
| Florida Limited Liability | 2019-09-16 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
