| Entity Name: | L.O.T. HEALTH SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 04 Dec 2014 (10 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 24 Oct 2016 (8 years ago) |
| Document Number: | N14000011062 |
| FEI/EIN Number | 47-2640945 |
| Address: | 11924 Forest Hill Blvd, Suite 10A-243, Wellington, FL, 33414, US |
| Mail Address: | 11924 Forest Hill Blvd, Suite 10A-243, Wellington, FL, 33414, US |
| ZIP code: | 33414 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1619367976 | 2015-01-26 | 2021-03-30 | 11924 FOREST HILL BLVD, SUITE 10A-243, WELLINGTON, FL, 334146256, US | 845 PALM BEACH RD, SOUTH BAY, FL, 334932037, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 561-693-5143 |
| Fax | 5612459150 |
Authorized person
| Name | MRS. MAGALI RODRIGUEZ-LOUIS |
| Role | EXECUTIVE DIRECTOR |
| Phone | 5616935143 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW8609 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME108802 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME49236 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| License Number | ME108802 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME68559 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | ME108802 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 363AM0700X - Medical Physician Assistant |
| License Number | PA9103904 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | ARNP9276312 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 109195200 |
| State | FL |
| Name | Role |
|---|---|
| THE FETTERMAN FIRM, PLLC | Agent |
| Name | Role | Address |
|---|---|---|
| Rodriguez-Louis Magali | President | 17631 30th Lane North, Loxahatchee, FL, 33470 |
| Name | Role | Address |
|---|---|---|
| LOUIS RODNEY | Secretary | 11924 Forest Hill Blvd, Wellington, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| CRONAN MICHAEL E | Vice President | 11924 Forest Hill Blvd, Wellington, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| LOTTMAN RAQUEL A | Treasurer | 11924 Forest Hill Blvd, Wellington, FL, 33414 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-02-04 | The Fetterman Firm, PLLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-04 | 1231 SW Sunset Trail, Palm City, FL 34990 | No data |
| NAME CHANGE AMENDMENT | 2016-10-24 | L.O.T. HEALTH SERVICES, INC. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-10-18 | 11924 Forest Hill Blvd, Suite 10A-243, Wellington, FL 33414 | No data |
| CHANGE OF MAILING ADDRESS | 2016-10-18 | 11924 Forest Hill Blvd, Suite 10A-243, Wellington, FL 33414 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-02 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-02-04 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-29 |
| ANNUAL REPORT | 2019-06-18 |
| ANNUAL REPORT | 2018-07-23 |
| ANNUAL REPORT | 2017-04-26 |
| Name Change | 2016-10-24 |
| AMENDED ANNUAL REPORT | 2016-10-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
