| Entity Name: | LAKELAND DENTAL PROFESSIONALS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Dec 2019 (5 years ago) |
| Document Number: | L20000007404 |
| FEI/EIN Number | 84-4295736 |
| Address: | 310 E HIGHLAND DR, LAKELAND, FL, 33813, US |
| Mail Address: | 310 E HIGHLAND DR, LAKELAND, FL, 33813, US |
| ZIP code: | 33813 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558991232 | 2020-01-22 | 2020-01-22 | 310 E HIGHLAND DR, LAKELAND, FL, 338131727, US | 310 E HIGHLAND DR, LAKELAND, FL, 338131727, US | |||||||||||||||||||||||||||||
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| Phone | +1 863-646-8511 |
Authorized person
| Name | COURTNEY MAYOR |
| Role | PARTNER/OWNER |
| Phone | 7274708554 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1699189803 |
| State | FL |
| Issuer | NPI |
| Number | 1144636788 |
| State | FL |
| Issuer | NPI |
| Number | 1922157619 |
| Name | Role | Address |
|---|---|---|
| MAYOR COURTNEY R | Agent | 310 E HIGHLAND DR, LAKELAND, FL, 33813 |
| Name | Role |
|---|---|
| RACHAEL YOPP, P.A. | Manager |
| COURTNEY RAE MAYOR, P.A. | Manager |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-05-13 |
| Florida Limited Liability | 2019-12-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
