| Entity Name: | J. AGUSTIN LACSON, M.D., INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 29 May 2002 (23 years ago) |
| Document Number: | P02000059287 |
| FEI/EIN Number | 04-3680671 |
| Address: | 3300 US 27S, AVON PARK, FL 33825 |
| Mail Address: | 3300 US 27S, AVON PARK, FL 33825 |
| ZIP code: | 33825 |
| County: | Highlands |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619931821 | 2006-04-14 | 2021-08-30 | PO BOX 7514, SEBRING, FL, 338720109, US | 3300 US 27 S, AVON PARK, FL, 338259701, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 863-385-6700 |
Authorized person
| Name | J. AGUSTIN LACSON |
| Role | OWNER |
| Phone | 8633856700 |
Taxonomy
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| License Number | ME0072358 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | 110241195 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LACSON, JANICE J, SEC | Agent | 3300 US 27N, AVON PARK, FL 33825 |
| Name | Role | Address |
|---|---|---|
| LACSON, J. AGUSTIN | President | 3300 US 27N, AVON PARK, FL 33825 |
| Name | Role | Address |
|---|---|---|
| LACSON, J. AGUSTIN | Secretary | 3300 US 27N, AVON PARK, FL 33825 |
| LACSON, JANICE J | Secretary | 3300 US 27N, AVON PARK, FL 33825 |
| Name | Role | Address |
|---|---|---|
| LACSON, J. AGUSTIN | Treasurer | 3300 US 27N, AVON PARK, FL 33825 |
| Name | Role | Address |
|---|---|---|
| LACSON, J. AGUSTIN | Director | 3300 US 27N, AVON PARK, FL 33825 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2020-05-13 | LACSON, JANICE J, SEC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-12-19 | 3300 US 27S, AVON PARK, FL 33825 | No data |
| CHANGE OF MAILING ADDRESS | 2011-12-19 | 3300 US 27S, AVON PARK, FL 33825 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-12-19 | 3300 US 27N, AVON PARK, FL 33825 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-25 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-02-14 |
| ANNUAL REPORT | 2021-02-16 |
| ANNUAL REPORT | 2020-05-13 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-04-16 |
| ANNUAL REPORT | 2017-03-13 |
| ANNUAL REPORT | 2016-04-06 |
| ANNUAL REPORT | 2015-03-25 |
Date of last update: 31 Jan 2025
Sources: Florida Department of State
