| Entity Name: | LAKE SUMTER UROLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Sep 2021 (3 years ago) |
| Document Number: | L21000406338 |
| FEI/EIN Number | 87-2678268 |
| Address: | 808 Highway 466, LADY LAKE, FL, 32159, US |
| Mail Address: | 808 Highway 466, LADY LAKE, FL, 32159, US |
| ZIP code: | 32159 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285385401 | 2022-01-11 | 2023-11-22 | 808 HIGHWAY 466, LADY LAKE, FL, 321593918, US | 808 HIGHWAY 466, LADY LAKE, FL, 321593918, US | |||||||||||||||
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| Phone | +1 352-775-6899 |
| Fax | 8773191879 |
Authorized person
| Name | VENKATA MARELLA |
| Role | OWNER AND AO |
| Phone | 3527756899 |
Taxonomy
| Taxonomy Code | 208800000X - Urology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MARELLA VENKATA | Agent | 808 Highway 466, LADY LAKE, FL, 32159 |
| Name | Role | Address |
|---|---|---|
| MARELLA VENKATA K | Authorized Member | 808 Highway 466, LADY LAKE, FL, 32159 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-09 | 808 Highway 466, LADY LAKE, FL 32159 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-09 | 808 Highway 466, LADY LAKE, FL 32159 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-09 | 808 Highway 466, LADY LAKE, FL 32159 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-03 |
| ANNUAL REPORT | 2023-02-09 |
| ANNUAL REPORT | 2022-08-16 |
| Florida Limited Liability | 2021-09-14 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
