| Entity Name: | WELAKA CLINIC, 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: | 17 Aug 2005 (20 years ago) |
| Date of dissolution: | 26 Sep 2008 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2008 (16 years ago) |
| Document Number: | N05000008459 |
| FEI/EIN Number |
203254644
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 405 ELM STREET, WELAKA, FL, 32193, US |
| Mail Address: | P.O. BOX 1110, WELAKA, FL, 32193, US |
| ZIP code: | 32193 |
| County: | Putnam |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1184651168 | 2006-06-27 | 2020-08-22 | PO BOX 1110, WELAKA, FL, 321931110, US | 405 ELM ST, WELAKA, FL, 321931110, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 386-467-3171 |
| Fax | 3864673174 |
Authorized person
| Name | GARY BUCKMAN |
| Role | ADMINISTRATOR |
| Phone | 3864673171 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS0006099 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS8101 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 17713 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME54534 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0059459 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME85684 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME75694 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| SANDS GORDON | Director | P.O. BOX 415, WELAKA, FL, 32193 |
| WILSON CHARLES | Director | P.O. BOX 54, WELAKA, FL, 32193 |
| JOHNSON ALFRED | Director | P.O. BOX 185, WELAKA, FL, 32193 |
| JOHNS EDDIE | Director | P.O. BOX 737, WELAKA, FL, 32193 |
| HASKELL JAMES | Director | 216 SPORTSMAN DRIVE, SATSUMA, FL, 32193 |
| SCOTT ALLEN | Agent | 99 ORANGE STREET, ST. AUGUSTINE, FL, 32084 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | - | - |
| AMENDMENT | 2007-01-29 | - | - |
| CHANGE OF MAILING ADDRESS | 2006-07-24 | 405 ELM STREET, WELAKA, FL 32193 | - |
| Name | Date |
|---|---|
| Amendment | 2007-01-29 |
| ANNUAL REPORT | 2007-01-29 |
| ANNUAL REPORT | 2006-07-24 |
| Domestic Non-Profit | 2005-08-17 |
Date of last update: 03 Mar 2025
Sources: Florida Department of State
