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MIS PROVIDER NETWORK LLC - Florida Company Profile

Company Details

Entity Name: MIS PROVIDER NETWORK LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

MIS PROVIDER NETWORK LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 13 Oct 2021 (3 years ago)
Date of dissolution: 22 Sep 2023 (a year ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 22 Sep 2023 (a year ago)
Document Number: L21000447391
FEI/EIN Number 87-3457267

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 170 FITZGERALD RD, SUITE 1, LAKELAND, FL, 33813
Mail Address: 170 FITZGERALD RD, SUITE 1, LAKELAND, FL, 33813
ZIP code: 33813
County: Polk
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1700529369 2022-04-20 2022-04-20 170 FITZGERALD RD STE 1, LAKELAND, FL, 338132633, US 170 FITZGERALD RD STE 1, LAKELAND, FL, 338132633, US

Contacts

Phone +1 813-687-5858

Authorized person

Name WENDY L BRADSHAW
Role OWNER
Phone 8136875858

Taxonomy

Taxonomy Code 101Y00000X - Counselor
Is Primary No
Taxonomy Code 101YM0800X - Mental Health Counselor
Is Primary No
Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

Key Officers & Management

Name Role Address
BRADSHAW WENDY L Manager 4210 OLD MULBERRY RD, PLANT CITY, FL, 33567
ROSSITER STEPHEN P Agent 170 FITZGERALD RD, LAKELAND, FL, 33813

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2023-09-22 - -

Documents

Name Date
ANNUAL REPORT 2022-03-08
Florida Limited Liability 2021-10-13

Date of last update: 01 Mar 2025

Sources: Florida Department of State