| Entity Name: | PRO2 LAKE CITY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 09 Jul 2004 (21 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | REVOKED FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | M04000002742 |
| FEI/EIN Number | 043667986 |
| Mail Address: | 2620 SW 17TH RD, OCALA, FL, 34471, US |
| Address: | 4550 SW 41 Blvd, Gainesville, FL, 32608, US |
| ZIP code: | 32608 |
| County: | Alachua |
| Place of Formation: | OHIO |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245265800 | 2006-07-12 | 2015-07-17 | 4550 SW 41ST BLVD, SUITE 7, GAINESVILLE, FL, 326084255, US | 4550 SW 41ST BLVD, SUITE 7, GAINESVILLE, FL, 32608, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 386-755-9511 |
| Fax | 3867559577 |
Authorized person
| Name | MR. TIMOTHY FORD |
| Role | PRESIDENT |
| Phone | 5134695771 |
Taxonomy
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| License Number | 1312130 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 031183900 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATE CREATIONS NETWORK INC. | Agent |
| Name | Role | Address |
|---|---|---|
| FORD TIMOTHY | Manager | 901 ADAMS CROSSING, CINCINNATI, OH, 45202 |
| Smith Douglas A | Manager | 9 Highland Ave, Fort Thomas, KY, 41075 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000021874 | PRO2 RESPIRATORY SERVICES | EXPIRED | 2012-03-02 | 2017-12-31 | No data | 155 N.W. ENTERPRISE WAY, SUITE 103, LAKE CITY, FL, 32055 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REVOKED FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2015-08-20 | 4550 SW 41 Blvd, Suite 7, Gainesville, FL 32608 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-14 | 4550 SW 41 Blvd, Suite 7, Gainesville, FL 32608 | No data |
| CANCEL ADM DISS/REV | 2007-10-08 | No data | No data |
| REVOKED FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| NAME CHANGE AMENDMENT | 2005-03-07 | PRO2 LAKE CITY, LLC | No data |
| REGISTERED AGENT NAME CHANGED | 2005-03-07 | CORPORATE CREATIONS NETWORK, INC. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-03-07 | 11380 PROSPERITY FARMS ROAD #221 E, PALM BEACH GARDENS, FL 33410 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J15000339065 | LAPSED | 2014-2906-CAB | MARION COUNTY | 2015-03-02 | 2020-03-06 | $31,642.09 | CARRIAGE HILL INVESTMENTS, INC., C/O RICHARD VARIO, P.O. BOX 5957, OCALA, FL 34478 |
| J15000339057 | LAPSED | 2014-2906-CAB | MARION COUNTY | 2015-03-02 | 2020-03-06 | $31,642.09 | CARRIAGE HILL INVESTMENTS, INC., C/O RICHARD VARIO, P.O. BOX 5957, OCALA, FL 34478 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-01-14 |
| ANNUAL REPORT | 2014-01-02 |
| ANNUAL REPORT | 2013-01-16 |
| ANNUAL REPORT | 2012-02-29 |
| ANNUAL REPORT | 2011-03-08 |
| ANNUAL REPORT | 2010-04-15 |
| ANNUAL REPORT | 2009-04-13 |
| ANNUAL REPORT | 2008-04-29 |
| REINSTATEMENT | 2007-10-08 |
| ANNUAL REPORT | 2006-06-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
