| Entity Name: | LAKE 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: | 14 Jul 2011 (14 years ago) |
| Date of dissolution: | 19 Oct 2020 (5 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 19 Oct 2020 (5 years ago) |
| Document Number: | N11000006738 |
| FEI/EIN Number |
452797089
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 315 WEST MAIN STREET, OFFICE OF EMS, TAVARES, FL, 32778, US |
| Mail Address: | PO Box 7800, TAVARES, FL, 32778, US |
| ZIP code: | 32778 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497034318 | 2011-08-09 | 2012-01-18 | 2761 WEST OLD HIGHWAY 441, MOUNT DORA, FL, 32757, US | 2761 WEST OLD HIGHWAY 441, MOUNT DORA, FL, 32757, US | |||||||||||||||||||||||||
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| Phone | +1 352-383-4554 |
| Fax | 3523859063 |
Authorized person
| Name | MR. WELTON G. CADWELL |
| Role | BOARD CHAIRMAN |
| Phone | 3523439850 |
Taxonomy
| Taxonomy Code | 3416L0300X - Land Ambulance |
| License Number | ALS3503 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004071400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SULLIVAN TIM | Director | 315 WEST MAIN STREET, TAVARES, FL, 32778 |
| BREEDEN WENDY | Director | 315 WEST MAIN STREET, TAVARES, FL, 32778 |
| CAMPIONE LESLIE | Director | 315 WEST MAIN STREET, TAVARES, FL, 32778 |
| PARKS SEAN M | Director | 315 WEST MAIN STREET, TAVARES, FL, 32778 |
| BLAKE JOSH | Director | 315 WEST MAIN STREET, TAVARES, FL, 32778 |
| MARSH MELANIE | Agent | LAKE COUNTY ATTORNEY, TAVARES, FL, 32778 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2020-10-19 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-06 | 315 WEST MAIN STREET, OFFICE OF EMS, TAVARES, FL 32778 | - |
| REGISTERED AGENT NAME CHANGED | 2019-02-06 | MARSH, MELANIE | - |
| CHANGE OF MAILING ADDRESS | 2018-11-08 | 315 WEST MAIN STREET, OFFICE OF EMS, TAVARES, FL 32778 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2018-11-08 | LAKE COUNTY ATTORNEY, 315 WEST MAIN STREET, TAVARES, FL 32778 | - |
| REINSTATEMENT | 2018-11-08 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | - | - |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2020-10-19 |
| ANNUAL REPORT | 2020-03-10 |
| ANNUAL REPORT | 2019-02-06 |
| REINSTATEMENT | 2018-11-08 |
| ANNUAL REPORT | 2017-02-23 |
| ANNUAL REPORT | 2016-01-26 |
| Reg. Agent Change | 2015-10-12 |
| ANNUAL REPORT | 2015-04-09 |
| ANNUAL REPORT | 2014-04-14 |
| ANNUAL REPORT | 2013-03-22 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
