| Entity Name: | MIL-LAKE MEDICAL TWO, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 01 Aug 2012 (13 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | P12000066781 |
| FEI/EIN Number | 46-0705872 |
| Address: | 555 N CONGRESS AVENUE, BOYNTON BEACH, FL, 33426, US |
| Mail Address: | 555 N CONGRESS AVENUE, BOYNTON BEACH, FL, 33426, US |
| ZIP code: | 33426 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821348616 | 2012-09-19 | 2012-09-19 | 2401 QUANTUM BLVD, BOYNTON BEACH, FL, 334268612, US | 2401 QUANTUM BLVD, BOYNTON BEACH, FL, 334268612, US | |||||||||||||||||||
|
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| Phone | +1 561-739-9333 |
| Fax | 5617399911 |
Authorized person
| Name | DR. DAVID ABELLARD |
| Role | ADMINISTRATOR |
| Phone | 5614334446 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| LABISSIERE JEAN-CLAUDE Dr. | Agent | 555 N CONGRESS AVENUE, BOYNTON BEACH, FL, 33426 |
| Name | Role | Address |
|---|---|---|
| LABISSIERE JEAN CLAUDE | Officer | 555 N CONGRESS AVENUE, BOYNTON BEACH, FL, 33426 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-03-18 | LABISSIERE, JEAN-CLAUDE, Dr. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-07-22 | 555 N CONGRESS AVENUE, 206, BOYNTON BEACH, FL 33426 | No data |
| CHANGE OF MAILING ADDRESS | 2016-07-22 | 555 N CONGRESS AVENUE, 206, BOYNTON BEACH, FL 33426 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-07-22 | 555 N CONGRESS AVENUE, 206, BOYNTON BEACH, FL 33426 | No data |
| AMENDMENT | 2012-09-10 | No data | No data |
| AMENDMENT | 2012-08-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-05-10 |
| ANNUAL REPORT | 2021-03-18 |
| ANNUAL REPORT | 2020-01-24 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-07-22 |
| ANNUAL REPORT | 2015-04-29 |
| ANNUAL REPORT | 2014-02-03 |
| ANNUAL REPORT | 2013-03-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
