| Entity Name: | LOTUS BLOSSOM CLINIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Sep 2007 (17 years ago) |
| Branch of: | LOTUS BLOSSOM CLINIC, LLC, COLORADO (Company Number 20001221660) |
| Document Number: | M07000005812 |
| FEI/EIN Number | 470929948 |
| Address: | 6710 WINKLER ROAD, SUITE 2, FORT MYERS, FL, 33919 |
| Mail Address: | 14651 Lake Olive Drive, Ft. Myers, FL, 33919, US |
| ZIP code: | 33919 |
| County: | Lee |
| Place of Formation: | COLORADO |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588931307 | 2011-11-22 | 2011-12-14 | 6710 WINKLER RD, SUITE #2, FORT MYERS, FL, 339197274, US | 6710 WINKLER RD, SUITE #2, FORT MYERS, FL, 339197274, US | |||||||||||||||||
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| Phone | +1 239-277-1399 |
Authorized person
| Name | DR. DAVID LEE MARTIN |
| Role | ACUPUNCTURE PHYSICIAN |
| Phone | 2392771399 |
Taxonomy
| Taxonomy Code | 171100000X - Acupuncturist |
| License Number | AP 2473 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MARTIN DAVID | Agent | 14651 Lake Olive Drive, Ft. Myers, FL, 33919 |
| Name | Role | Address |
|---|---|---|
| MARTIN DAVID L | Managing Member | 14651 Lake Olive Drive, Ft. Myers, FL, 33919 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2017-02-09 | 6710 WINKLER ROAD, SUITE 2, FORT MYERS, FL 33919 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-02-09 | 14651 Lake Olive Drive, Ft. Myers, FL 33919 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-01-05 | 6710 WINKLER ROAD, SUITE 2, FORT MYERS, FL 33919 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-03-06 |
| ANNUAL REPORT | 2021-04-08 |
| ANNUAL REPORT | 2020-03-17 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-03-08 |
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-02-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
