| Entity Name: | LOBATO FAMILY PRACTICE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Aug 2020 (4 years ago) |
| Document Number: | L20000241711 |
| FEI/EIN Number | 852655347 |
| Address: | 900 Orchid Springs Dr STE 102, WINTER HAVEN, FL, 33884, US |
| Mail Address: | 900 Orchid Springs Dr STE 102, WINTER HAVEN, FL, 33884, US |
| ZIP code: | 33884 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295339364 | 2020-11-29 | 2023-07-31 | 112 LAKE CHARLES DR, DAVENPORT, FL, 338373607, US | 900 ORCHID SPRINGS DR STE 102, WINTER HAVEN, FL, 338843655, US | |||||||||||||
|
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| Phone | +1 305-322-5907 |
Authorized person
| Name | ERICA LOBATO |
| Role | OWNER |
| Phone | 3053225907 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LOBATO ALEXANDER | Agent | 112 LAKE CHARLES DR, DAVENPORT, FL, 33837 |
| Name | Role | Address |
|---|---|---|
| LOBATO ERICA | Authorized Member | 112 LAKE CHARLES DR, DAVENPORT, FL, 33827 |
| Name | Role | Address |
|---|---|---|
| LOBATO ALEXANDER | Manager | 112 LAKE CHARLES DR, DAVENPORT, FL, 33837 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-12-19 | 900 Orchid Springs Dr STE 102, WINTER HAVEN, FL 33884 | No data |
| CHANGE OF MAILING ADDRESS | 2022-12-19 | 900 Orchid Springs Dr STE 102, WINTER HAVEN, FL 33884 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-13 |
| ANNUAL REPORT | 2023-03-29 |
| ANNUAL REPORT | 2022-04-11 |
| ANNUAL REPORT | 2021-02-09 |
| Florida Limited Liability | 2020-08-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
