| Entity Name: | LAKESIDE OF LAKELAND, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 05 Nov 2010 (14 years ago) |
| Date of dissolution: | 29 Dec 2014 (10 years ago) |
| Last Event: | CORPORATE MERGER |
| Event Date Filed: | 29 Dec 2014 (10 years ago) |
| Document Number: | P10000090075 |
| FEI/EIN Number | 27-4012691 |
| Address: | 7527 ULMERTON RD, LARGO, FL 33771 |
| Mail Address: | 7527 ULMERTON RD, LARGO, FL 33771 |
| ZIP code: | 33771 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518246370 | 2011-08-11 | 2011-08-11 | 7527 ULMERTON RD, LARGO, FL, 337714548, US | 5040 US HIGHWAY 98 N, LAKELAND, FL, 338090511, US | |||||||||||||||||
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| Phone | +1 863-859-3511 |
Authorized person
| Name | MRS. ARLENE GUZIK |
| Role | VP OPERATIONS |
| Phone | 7275327644 |
Taxonomy
| Taxonomy Code | 261QX0100X - Occupational Medicine Clinic/Center |
| License Number | ME 25396 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Johnson, Richard F, MD | Agent | 7527 ULMERTON RD, LARGO, FL 33771 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, RICHARD F, MD | President | 4548 CLEARWATER HARBOR DR SOUTH, LARGO, FL 33770 |
| Name | Role | Address |
|---|---|---|
| jacobsen, brenda l, CPA | sec | 7527 ULMERTON RD, LARGO, FL 33771 |
| Name | Role | Address |
|---|---|---|
| jacobsen, brenda l, CPA | treas | 7527 ULMERTON RD, LARGO, FL 33771 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000020653 | OCCUPATIONAL SPECIALISTS | EXPIRED | 2011-02-24 | 2016-12-31 | No data | 7527 ULMERTON ROAD, LARGO, FL, 33771 |
| G11000020661 | LAKESIDE MEDICAL URGENT CARE | EXPIRED | 2011-02-24 | 2016-12-31 | No data | 7527 ULMERTON ROAD, LARGO, FL, 33771 |
| G11000020665 | LAKESIDE MEDICAL URGENT CARE | EXPIRED | 2011-02-24 | 2016-12-31 | No data | 7527 ULMERTON ROAD, LARGO, FL, 33771 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| MERGER | 2014-12-29 | No data | CORPORATION WAS PART OF A MERGER. QUALIFIED CORPORATION WAS 526379. MERGER NUMBER 100000147841 |
| AMENDMENT | 2014-04-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-09 | Johnson, Richard F, MD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-09 | 7527 ULMERTON RD, LARGO, FL 33771 | No data |
| Name | Date |
|---|---|
| Amendment | 2014-04-24 |
| ANNUAL REPORT | 2014-04-07 |
| ANNUAL REPORT | 2013-04-09 |
| ANNUAL REPORT | 2012-04-02 |
| ANNUAL REPORT | 2011-03-24 |
| Domestic Profit | 2010-11-05 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
