| Entity Name: | LAKES MALL DENTAL CENTER, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 13 Sep 2012 (12 years ago) |
| Date of dissolution: | 27 Sep 2024 (5 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (5 months ago) |
| Document Number: | P12000077844 |
| FEI/EIN Number | 46-1312076 |
| Address: | 11401 PINES BLVD, STE 220, PEMBROKE PINES, FL 33026 |
| Mail Address: | 11401 PINES BLVD, STE 220, PEMBROKE PINES, FL 33026 |
| ZIP code: | 33026 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063757912 | 2012-12-04 | 2012-12-04 | 1830 S OCEAN DR APT 2204, HALLANDALE BEACH, FL, 330097695, US | 11401 PINES BLVD STE 220, PEMBROKE PINES, FL, 330264104, US | |||||||||||||||||||
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| Phone | +1 305-951-9988 |
| Phone | +1 954-432-5515 |
Authorized person
| Name | DR. ERIK O CALDERON |
| Role | PRESIDENT |
| Phone | 3059519988 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 19377 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Calderon, Erik O. | Agent | 11401 Pines Boulevard, #220, Pembroke Pines, FL 33026 |
| Name | Role | Address |
|---|---|---|
| Calderon, Erik O. | President | 11401 Pines Boulevard #220, Pembroke Pines, FL 33026 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000103427 | DENTILIFE | EXPIRED | 2018-09-19 | 2023-12-31 | No data | 1518 WEST 49TH AVENUE, HIALEAH, FL, 33012 |
| G17000015495 | DENTILIVE | EXPIRED | 2017-02-10 | 2022-12-31 | No data | 1518 WEST 49TH AVENUE, HIALEAH, FL, 33012 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-09-17 | Calderon, Erik O. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-09-17 | 11401 Pines Boulevard, #220, Pembroke Pines, FL 33026 | No data |
| AMENDMENT | 2012-12-27 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J23000533125 | ACTIVE | COCE23057319 | BROWARD COUNTY COURT CLERK | 2023-09-20 | 2028-11-08 | $6,698.50 | ROSADO DENTAL LAB CORP, 8000 W 24TH AVE BAY 2, HIALEAH, FL, 33016 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-03-17 |
| ANNUAL REPORT | 2021-03-27 |
| ANNUAL REPORT | 2020-06-17 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-03-06 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-29 |
| ANNUAL REPORT | 2014-05-19 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6282597306 | 2020-04-30 | 0455 | PPP | 11401 Pines Blvd Suite 220, pembroke Pine, FL, 33026 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 22 Feb 2025
Sources: Florida Department of State
