| Entity Name: | LIFE SPECIALTY PHARMACY, MEDICAL EQUIPMENT & SUPPLIES INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 02 Dec 2004 (20 years ago) |
| Date of dissolution: | 22 Jul 2010 (15 years ago) |
| Last Event: | VOLUNTARY DISS W/ NOTICE |
| Event Date Filed: | 22 Jul 2010 (15 years ago) |
| Document Number: | P04000162052 |
| FEI/EIN Number | 432071350 |
| Address: | 1507 PARK CENTER DRIVE, SUITE 1K, ORLANDO, FL, 32835, OR |
| Mail Address: | 7459 HIGH LAKE DRIVE, ORLANDO, FL, 32818, OR |
| ZIP code: | 32835 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1659441624 | 2006-11-08 | 2008-06-05 | 1507 PARK CENTER DRIVE, SUITE 1K, ORLANDO, FL, 328355795, US | 1507 PARK CENTER DRIVE, SUITE 1K, ORLANDO, FL, 328355795, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-522-5683 |
| Fax | 4075225684 |
| Phone | +1 407-405-0735 |
Authorized person
| Name | MICHAEL AYOTUNDE |
| Role | PRESIDENT OWNER |
| Phone | 4075225683 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH 22346 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0002X - Clinic Pharmacy |
| License Number | PH 22346 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | PH 22346 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336H0001X - Home Infusion Therapy Pharmacy |
| License Number | PH 22346 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336I0012X - Institutional Pharmacy |
| License Number | PH 22346 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | PH 22346 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336M0002X - Mail Order Pharmacy |
| License Number | PH 22346 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1659441624 |
| State | FL |
| Issuer | MEDICAID |
| Number | 031807800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AYOTUNDE MICHAEL S | Agent | 7459 HIGH LAKE DRIVE, ORLANDO, FL, 32818 |
| Name | Role | Address |
|---|---|---|
| AYOTUNDE MICHAEL S | President | 7459 HIGH LAKE DRIVE, ORLANDO, FL, 32818 |
| Name | Role | Address |
|---|---|---|
| AYOTUNDE MICHAEL S | Director | 7459 HIGH LAKE DRIVE, ORLANDO, FL, 32818 |
| Name | Role | Address |
|---|---|---|
| AYOTUNDE ELIZABETH S | Vice President | 7459 HIGH LAKE DRIVE, ORLANDO, FL, 32818 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISS W/ NOTICE | 2010-07-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-04-21 | 1507 PARK CENTER DRIVE, SUITE 1K, ORLANDO, FL 32835 OR | No data |
| CHANGE OF MAILING ADDRESS | 2008-04-21 | 1507 PARK CENTER DRIVE, SUITE 1K, ORLANDO, FL 32835 OR | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J10000023694 | LAPSED | 08-CC-16683 | COUNTY COURT ORANGE COUNTY,FL | 2009-12-14 | 2015-01-27 | $9,209.92 | ANDA PHARMACEUTICALS, INC., VALUE IN PHARMACEUTICALS, VIP PHARMACEUTICALS, 2915 WESTON ROAD, WESTON, FL 33331 |
| Name | Date |
|---|---|
| CORAPVDWN | 2010-07-22 |
| ANNUAL REPORT | 2009-04-27 |
| ANNUAL REPORT | 2008-04-21 |
| ANNUAL REPORT | 2007-04-16 |
| ANNUAL REPORT | 2006-04-17 |
| ANNUAL REPORT | 2005-04-27 |
| Domestic Profit | 2004-12-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
