| Entity Name: | HEALTHWORKS OF LAKE CITY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 24 Jan 2001 (24 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 17 Nov 2011 (13 years ago) |
| Document Number: | P01000009645 |
| FEI/EIN Number | 593694013 |
| Address: | 1206 SW MAIN BLVD, SUITE 101, LAKE CITY, FL, 32025 |
| Mail Address: | 1206 SW MAIN BLVD, SUITE 101, LAKE CITY, FL, 32025 |
| ZIP code: | 32025 |
| County: | Columbia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245235183 | 2005-06-16 | 2012-01-12 | 1206 SW MAIN BLVD, STE 101, LAKE CITY, FL, 320256684, US | 1206 SW MAIN BLVD, STE 101, LAKE CITY, FL, 320256684, US | |||||||||||||||||||||||||
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| Phone | +1 386-752-1652 |
| Fax | 3867520939 |
Authorized person
| Name | MICHAEL A BEARDSLEY |
| Role | OWNER/ADMINISTRATOR |
| Phone | 3867521652 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | PT17329 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS PROVIDER NUMBER |
| Number | Y7572 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BEARDSLEY MICHAEL A | Agent | 1206 SW MAIN BLVD, LAKE CITY, FL, 32025 |
| Name | Role | Address |
|---|---|---|
| BEARDSLEY MICHAEL A | President | 1206 MAIN BLVD STE 101, LAKE CITY, FL, 32025 |
| Name | Role | Address |
|---|---|---|
| BEARDSLEY MICHAEL A | Secretary | 1206 MAIN BLVD STE 101, LAKE CITY, FL, 32025 |
| Beardsley Elizabeth | Secretary | 1206 SW MAIN BLVD, LAKE CITY, FL, 32025 |
| Name | Role | Address |
|---|---|---|
| BEARDSLEY MICHAEL A | Treasurer | 1206 MAIN BLVD STE 101, LAKE CITY, FL, 32025 |
| Name | Role | Address |
|---|---|---|
| BEARDSLEY MICHAEL A | Director | 1206 MAIN BLVD STE 101, LAKE CITY, FL, 32025 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| REINSTATEMENT | 2011-11-17 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-11-17 | 1206 SW MAIN BLVD, SUITE 101, LAKE CITY, FL 32025 | No data |
| CHANGE OF MAILING ADDRESS | 2011-11-17 | 1206 SW MAIN BLVD, SUITE 101, LAKE CITY, FL 32025 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-04-30 | 1206 SW MAIN BLVD, STE 101, LAKE CITY, FL 32025 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-05 |
| ANNUAL REPORT | 2023-03-29 |
| ANNUAL REPORT | 2022-04-01 |
| ANNUAL REPORT | 2021-04-12 |
| ANNUAL REPORT | 2020-04-02 |
| ANNUAL REPORT | 2019-04-10 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-04-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
