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WELAKA CLINIC, INC. - Florida Company Profile

Company Details

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

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1184651168 2006-06-27 2020-08-22 PO BOX 1110, WELAKA, FL, 321931110, US 405 ELM ST, WELAKA, FL, 321931110, US

Contacts

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

Key Officers & Management

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

Events

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 -

Documents

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