| Entity Name: | JOSE A. LOPEZ, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 27 May 2003 (22 years ago) |
| Date of dissolution: | 01 Oct 2004 (20 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 01 Oct 2004 (20 years ago) |
| Document Number: | P03000058076 |
| Address: | 120 NORTH BLVD EAST, LEESBURG, FL, 34748 |
| Mail Address: | 19501 SPRING OAK DRIVE, EUSTIS, FL, 32736 |
| ZIP code: | 34748 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861705725 | 2010-07-21 | 2011-02-23 | 30 REMINGTON RD, SUITE 2, OAKLAND, FL, 347879797, US | 30 REMINGTON RD, SUITE 2, OAKLAND, FL, 347879797, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 407-392-1919 |
| Fax | 4073921917 |
Authorized person
| Name | DR. JOSE A LOPEZ |
| Role | OWNER |
| Phone | 4073921919 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME86165 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SEWELL STEPHEN G | Agent | 907 WEBSTER STREET, LEESBURG, FL, 34748 |
| Name | Role | Address |
|---|---|---|
| LOPEZ JOSE A | President | 19501 SPRING OAK DRIVE, EUSTIS, FL, 32736 |
| Name | Role | Address |
|---|---|---|
| LOPEZ JOSE A | Secretary | 19501 SPRING OAK DRIVE, EUSTIS, FL, 32736 |
| Name | Role | Address |
|---|---|---|
| LOPEZ JOSE A | Treasurer | 19501 SPRING OAK DRIVE, EUSTIS, FL, 32736 |
| Name | Role | Address |
|---|---|---|
| LOPEZ JOSE A | Director | 19501 SPRING OAK DRIVE, EUSTIS, FL, 32736 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2003-05-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
