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