| Entity Name: | CALOOSA MEDICAL CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 04 Dec 2019 (5 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: | L19000296905 |
| FEI/EIN Number | 84-3866774 |
| Mail Address: | 5180 JACKSON RD, FORT MYERS, FL 33905 |
| Address: | 14651 PALM BEACH BLVD., SUITE 100, FORT MYERS, FL 33905 |
| ZIP code: | 33905 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295373660 | 2019-12-17 | 2019-12-17 | 5180 JACKSON RD, FORT MYERS, FL, 339057518, US | 14651 PALM BEACH BLVD STE 100, FORT MYERS, FL, 339052331, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 239-849-6620 |
Authorized person
| Name | DR. CLARENNCE A SCOTT |
| Role | MANAGING PARTNER |
| Phone | 2398496620 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SCOTT, CLARENCE A | Agent | 5180 JACKSON RD, FORT MYERS, FL 33905 |
| Name | Role | Address |
|---|---|---|
| SCOTT, CLARENCE A | Manager | 5180 JACKSON RD, FORT MYERS, FL 33905 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-01-24 |
| Florida Limited Liability | 2019-12-04 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
