| Entity Name: | LAKE-SUMTER EMERGENCY MEDICAL SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| 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: | 30 Jun 2000 (25 years ago) |
| Date of dissolution: | 03 Nov 2011 (13 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 03 Nov 2011 (13 years ago) |
| Document Number: | N00000004386 |
| FEI/EIN Number |
593662117
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 2761 W OLD HWY 441, MOUNT DORA, FL, 32757 |
| Mail Address: | 2761 W OLD HWY 441, MOUNT DORA, FL, 32757 |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316931512 | 2005-09-02 | 2014-04-08 | 2761 W OLD US HWY 441, MOUNT DORA, FL, 327573500, US | 2761 W OLD US HIGHWAY 441, MOUNT DORA, FL, 327573500, US | |||||||||||||||||||||||||
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| Phone | +1 352-383-4554 |
| Fax | 3523859063 |
Authorized person
| Name | MR. BRYAN PORTER ANDREWS |
| Role | PFS MANAGER |
| Phone | 3523852530 |
Taxonomy
| Taxonomy Code | 3416L0300X - Land Ambulance |
| License Number | 2513 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 400077300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CADWELL WELTON G | Manager | 315 W. MAIN ST, TAVARES, FL, 32778 |
| HOFFMAN RICHARD | Manager | 8033 EAST CR 466, SUITE #100, LADY LAKE, FL, 32162 |
| KELLY NEIL | Manager | 550 W. MAIN ST, TAVARES, FL, 32778 |
| SHUMAKER CECIL | Manager | 1314 HOWARD RD, LEESBURG, FL, 34748 |
| MATTISON KEN | Manager | 1000 WATERMAN WAY, TAVARES, FL, 32778 |
| WOLF ED G | Manager | 100 NORTH MAINT STREET, WILDWOOD, FL, 34785 |
| MINKOFF SANDY A | Agent | 315 W MAIN ST, TAVARES, FL, 32778 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2011-11-03 | - | FILED WITH PLAN OF DISTRIBUTION OF ASSETS |
| REGISTERED AGENT ADDRESS CHANGED | 2010-01-06 | 315 W MAIN ST, TAVARES, FL 32778 | - |
| REGISTERED AGENT NAME CHANGED | 2007-01-12 | MINKOFF, SANDY ATT | - |
| CHANGE OF PRINCIPAL ADDRESS | 2003-03-25 | 2761 W OLD HWY 441, MOUNT DORA, FL 32757 | - |
| CHANGE OF MAILING ADDRESS | 2003-03-25 | 2761 W OLD HWY 441, MOUNT DORA, FL 32757 | - |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2011-11-03 |
| ANNUAL REPORT | 2011-02-22 |
| ANNUAL REPORT | 2010-01-06 |
| ANNUAL REPORT | 2009-01-20 |
| ANNUAL REPORT | 2008-02-07 |
| ANNUAL REPORT | 2007-01-12 |
| ANNUAL REPORT | 2006-04-18 |
| ANNUAL REPORT | 2005-01-27 |
| ANNUAL REPORT | 2004-03-03 |
| ANNUAL REPORT | 2003-03-25 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
