| Entity Name: | LAKE WALES MEDICAL IMAGING CENTER ONE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 14 Aug 2008 (16 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P08000076054 |
| FEI/EIN Number | 263176048 |
| Address: | 1255 HIGHWAY 60 EAST, 110, LAKE WALES, FL, 33853 |
| Mail Address: | 1255 HIGHWAY 60 EAST, 110, LAKE WALES, FL, 33853 |
| ZIP code: | 33853 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063657955 | 2008-12-08 | 2008-12-08 | 2301 LONGLEAF BLVD SUITE 200, LAKE WALES, FL, 33859, US | 1255 HIGHWAY 60 EAST 110, LAKE WALES, FL, 33853, US | |||||||||||||
|
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| Phone | +1 863-232-5111 |
Authorized person
| Name | DR. KOLLAGUNTA CHANDRASEKHAR |
| Role | PRESIDENT |
| Phone | 8632325111 |
Taxonomy
| Taxonomy Code | 247000000X - Health Information Technician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PRESLEY MICHAEL R | Agent | 10006 CROSS CREEK BLVD., TAMPA, FL, 33647 |
| Name | Role | Address |
|---|---|---|
| CHANDRASEKHAR KOLLAGUNTA | Manager | 1255 STATE ROAD 60 E, LAKE WALES, FL, 33853 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-04-29 |
| ANNUAL REPORT | 2009-04-30 |
| Domestic Profit | 2008-08-14 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
