| Entity Name: | LAKE WORTH DIAGNOSTIC TESTING GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 23 Oct 2002 (22 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | P02000114940 |
| FEI/EIN Number | 364512287 |
| Address: | 1836 MONTE CARLO WAY, CORAL SPRINGS, FL, 33071 |
| Mail Address: | 1836 MONTE CARLO WAY, CORAL SPRINGS, FL, 33071 |
| ZIP code: | 33071 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104957182 | 2007-03-08 | 2008-05-13 | 3713 S CONGRESS AVE, LAKE WORTH, FL, 334613753, US | 3713 S CONGRESS AVE, LAKE WORTH, FL, 334613753, US | |||||||||||||||||||||||
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| Phone | +1 561-964-8414 |
| Fax | 3054128265 |
Authorized person
| Name | MR. STEPHEN E CIANCIULLI |
| Role | PRESIDENT |
| Phone | 3052756069 |
Taxonomy
| Taxonomy Code | 261QM1200X - Magnetic Resonance Imaging (MRI) Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QR0200X - Radiology Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WEINBERG STEVEN A | Agent | 7805 SW SIXTH COURT, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| CIANCIULLI STEPHEN | Director | 9485 SUNSET PARK DRIVE STE A-150, MIAMI, FL, 33173 |
| GOBSTEIN HAROLD | Director | 1836 MONTE CARLO WAY, CORAL SPRINGS, FL, 33071 |
| Name | Role | Address |
|---|---|---|
| CIANCIULLI STEPHEN | President | 9485 SUNSET PARK DRIVE STE A-150, MIAMI, FL, 33173 |
| Name | Role | Address |
|---|---|---|
| GOBSTEIN HAROLD | Secretary | 1836 MONTE CARLO WAY, CORAL SPRINGS, FL, 33071 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| NAME CHANGE AMENDMENT | 2003-01-17 | LAKE WORTH DIAGNOSTIC TESTING GROUP, INC. | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001146902 | LAPSED | 1000000385454 | MIAMI-DADE | 2013-06-18 | 2023-06-26 | $ 1,201.84 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, WEST PALM BEACH SERVICE CENTER, 2468 METROCENTRE BLVD, WEST PALM BEACH FL334073105 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-04-23 |
| ANNUAL REPORT | 2007-04-29 |
| ANNUAL REPORT | 2006-05-01 |
| ANNUAL REPORT | 2005-05-03 |
| ANNUAL REPORT | 2004-05-04 |
| ANNUAL REPORT | 2003-04-25 |
| Name Change | 2003-01-17 |
| Domestic Profit | 2002-10-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
