| Entity Name: | SOUTHLAKE FAMILY PRACTICE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 26 May 2004 (21 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P04000083538 |
| FEI/EIN Number | 201212753 |
| Address: | 308 KINGSLEY LAKE DRIVE, SUITE 802, ST. AUGUSTINE, FL, 32092 |
| Mail Address: | 308 KINGSLEY LAKE DRIVE, SUITE 802, ST. AUGUSTINE, FL, 32092 |
| ZIP code: | 32092 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| Name | Role | Address |
|---|---|---|
| KALUZA MALGORZATA | Agent | 3634 PARADISE WAY, JACKSONVILLE BEACH, FL, 32250 |
| Name | Role | Address |
|---|---|---|
| KALUZA MALGORZATA | President | 3634 PARADISE WAY, JACKSONVILLE BEACH, FL, 32250 |
| Name | Role | Address |
|---|---|---|
| KALUZA MALGORZATA | Vice President | 3634 PARADISE WAY, JACKSONVILLE BEACH, FL, 32250 |
| Name | Role | Address |
|---|---|---|
| KALUZA PIOTR | Secretary | 3634 PARADISE WAY, JACKSONVILLE BEACH, FL, 32250 |
| Name | Role | Address |
|---|---|---|
| KALUZA PIOTR | Treasurer | 3634 PARADISE WAY, JACKSONVILLE BEACH, FL, 32250 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-17 | 3634 PARADISE WAY, JACKSONVILLE BEACH, FL 32250 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-01-11 | 308 KINGSLEY LAKE DRIVE, SUITE 802, ST. AUGUSTINE, FL 32092 | No data |
| CHANGE OF MAILING ADDRESS | 2010-01-11 | 308 KINGSLEY LAKE DRIVE, SUITE 802, ST. AUGUSTINE, FL 32092 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-04-08 |
| ANNUAL REPORT | 2019-02-04 |
| ANNUAL REPORT | 2018-03-19 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-03-19 |
| ANNUAL REPORT | 2014-03-20 |
| ANNUAL REPORT | 2013-04-17 |
| ANNUAL REPORT | 2012-04-17 |
| ANNUAL REPORT | 2011-01-06 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
