| Entity Name: | SAND LAKE HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 11 Mar 2021 (4 years ago) |
| Document Number: | L21000117028 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 8751 COMMODITY CIRCLE, UNIT 4, ORLANDO, FL, 32819 |
| Mail Address: | 12386 STATE ROAD 535, PMB 278, ORLANDO, FL, 32836 |
| ZIP code: | 32819 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730759937 | 2021-06-29 | 2021-06-29 | 8751 COMMODITY CIR STE 4, ORLANDO, FL, 328199027, US | 8751 COMMODITY CIR STE 4, ORLANDO, FL, 328199027, US | |||||||||||||||
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| Phone | +1 321-418-8005 |
| Fax | 8446933406 |
Authorized person
| Name | DR. KHIZAR MALIK |
| Role | CEO |
| Phone | 4072798470 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KHIZAR MALIK | Agent | 12386 STATE ROAD 535, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| MALIK AMEENA | Auth | 12386 STATE ROAD 535 PMB 278, ORLANDO, FL, 32836 |
| MALIK ALI | Auth | 12386 STATE ROAD 535 PMB 278, ORLANDO, FL, 32836 |
| Malik khizar | Auth | 12386 STATE ROAD 535, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| Malik Khizar | Manager | 12386 STATE ROAD 535, ORLANDO, FL, 32836 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-13 |
| ANNUAL REPORT | 2023-03-16 |
| ANNUAL REPORT | 2022-04-08 |
| Florida Limited Liability | 2021-03-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
