| Entity Name: | THE MEDICAL CENTRE OF LEHIGH ACRES, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 Mar 2010 (15 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 29 Apr 2021 (4 years ago) |
| Document Number: | P10000023377 |
| FEI/EIN Number | 272213206 |
| Address: | 1303 HOMESTEAD ROAD NORTH, SUITE # 102-103, LEHIGH ACRES, FL, 33936, US |
| Mail Address: | 1303 HOMESTEAD ROAD NORTH, SUITE #102, LEHIGH ACRES, FL, 33936, US |
| ZIP code: | 33936 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508179490 | 2010-07-20 | 2020-11-24 | 1303 HOMESTEAD RD N STE 102, LEHIGH ACRES, FL, 339366049, US | 1303 HOMESTEAD RD N STE 102, LEHIGH ACRES, FL, 339366049, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 239-303-2700 |
| Fax | 2393032756 |
Authorized person
| Name | RALPH S RYBACK |
| Role | PRESIDENT |
| Phone | 2393032700 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | ME 92563 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | 1508179490 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA EXEMPTION |
| Number | HCC8330 |
| State | FL |
| Issuer | NPI |
| Number | 1508179490 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MORALES ROSA E DIREC | Agent | 1303 HOMESTEAD ROAD NORTH, LEHIGH ACRES, FL, 33936 |
| Name | Role | Address |
|---|---|---|
| RYBACK RALPH SDr. | President | 1303 HOMESTEAD ROAD NORTH, SUITE #102, LEHIGH ACRES, FL, 33936 |
| Name | Role | Address |
|---|---|---|
| MORALES PETER | Chief Executive Officer | 1303 HOMESTEAD RD N, LEHIGH ACRES, FL, 33936 |
| Name | Role | Address |
|---|---|---|
| SOSA JAVIER EDr. | Chief Operating Officer | 1303 HOMESTEAD RD N, LEHIGH ACRES, FL, 33936 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-01-21 | MORALES, ROSA, E DIRECTOR | No data |
| AMENDMENT | 2021-04-29 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-17 | 1303 HOMESTEAD ROAD NORTH, SUITE # 102-103, LEHIGH ACRES, FL 33936 | No data |
| CHANGE OF MAILING ADDRESS | 2011-01-26 | 1303 HOMESTEAD ROAD NORTH, SUITE # 102-103, LEHIGH ACRES, FL 33936 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-01-26 | 1303 HOMESTEAD ROAD NORTH, SUITE #102, LEHIGH ACRES, FL 33936 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-01-21 |
| ANNUAL REPORT | 2022-01-25 |
| Amendment | 2021-04-29 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-03-31 |
| ANNUAL REPORT | 2018-03-17 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-01-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
