| Entity Name: | CLERMONT ENDODONTIC SPECIALIST, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 12 Dec 2007 (17 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P07000131377 |
| FEI/EIN Number | 26-1580199 |
| Address: | 265 HATTERAS AVE, SUITE 2, CLERMONT, FL 34711 |
| Mail Address: | 1200 NETWORK CENTRE DR, SUITE 2, EFFINGHAM, IL 62401 |
| ZIP code: | 34711 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932467461 | 2012-05-03 | 2012-05-03 | 265 HATTERAS AVE, SUITE 2, CLERMONT, FL, 347117400, US | 265 HATTERAS AVE, SUITE 2, CLERMONT, FL, 347117400, US | |||||||||||||||
|
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| Phone | +1 352-394-0150 |
| Fax | 3522430654 |
Authorized person
| Name | PAM HARDIEK |
| Role | CREDENTIALING/INSURANCE |
| Phone | 2175405100 |
Taxonomy
| Taxonomy Code | 1223E0200X - Endodontist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SINOPOLI, DARREN | Agent | 265 HATTERAS AVE, SUITE 2, CLERMONT, FL 34711 |
| Name | Role | Address |
|---|---|---|
| SINOPOLI, DARREN | President | 265 HATTERAS AVE, SUITE 2, CLERMONT, FL 34711 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000114381 | LAKELAND ENDODONTICS | EXPIRED | 2014-11-13 | 2019-12-31 | No data | 1200 NETWORK CENTRE DR, EFFINGHAM, IL, 62401 |
| G12000069720 | CLERMONT ENDODONTIC SPECIALIST | ACTIVE | 2012-07-12 | 2027-12-31 | No data | 265 HATTERAS AVE STE 2, CLERMONT, FL, 34711 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2013-03-20 | 265 HATTERAS AVE, SUITE 2, CLERMONT, FL 34711 | No data |
| AMENDMENT AND NAME CHANGE | 2012-07-06 | CLERMONT ENDODONTIC SPECIALIST, P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-21 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-01-07 |
| ANNUAL REPORT | 2015-04-02 |
| ANNUAL REPORT | 2014-04-15 |
| ANNUAL REPORT | 2013-03-20 |
| Amendment and Name Change | 2012-07-06 |
| ANNUAL REPORT | 2012-02-08 |
| ANNUAL REPORT | 2011-01-31 |
| ANNUAL REPORT | 2010-04-29 |
Date of last update: 26 Jan 2025
Sources: Florida Department of State
