| Entity Name: | LORA COLEMAN, LCSW, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 23 Jun 2006 (19 years ago) |
| Document Number: | P06000085603 |
| FEI/EIN Number | 342065862 |
| Address: | 3018 SE 29TH LN, GAINESVILLE, FL, 32641, US |
| Mail Address: | 3018 SE 29 lane, Gainesville, FL, 32641, US |
| ZIP code: | 32641 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609160191 | 2011-06-02 | 2019-01-22 | 20230 SW 105TH AVE, CUTLER BAY, FL, 331891313, US | 10700 CARIBBEAN BLVD STE 203, CUTLER BAY, FL, 331891224, US | |||||||||||||||||||||||||||
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| Phone | +1 305-298-6561 |
| Fax | 7862939985 |
| Fax | 3059691293 |
Authorized person
| Name | DR. LORA A COLEMAN |
| Role | OWNER |
| Phone | 3052986561 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW7978 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000031800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| COLEMAN LORA L | Agent | 3018 SE 29 lane, Gainesville, FL, 32641 |
| Name | Role | Address |
|---|---|---|
| Coleman Lora L | President | 3018 SE 29 lane, Gainesville, FL, 32641 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09008900213 | MARTHA'S EARTHCHILD APOTHECARY AND NATURAL HEALING CENTER | EXPIRED | 2009-01-08 | 2014-12-31 | No data | 9351 S.W. 165TH ST., MIAMI, FL, 33157 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-20 | 3018 SE 29TH LN, GAINESVILLE, FL 32641 | No data |
| CHANGE OF MAILING ADDRESS | 2020-02-16 | 3018 SE 29TH LN, GAINESVILLE, FL 32641 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-02-16 | 3018 SE 29 lane, Gainesville, FL 32641 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-19 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-04-18 |
| ANNUAL REPORT | 2021-03-20 |
| ANNUAL REPORT | 2020-02-16 |
| ANNUAL REPORT | 2019-04-10 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-02-07 |
| ANNUAL REPORT | 2016-03-30 |
| ANNUAL REPORT | 2015-04-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
