| Entity Name: | LAKE WALES FOOT AND ANKLE CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 Apr 2016 (9 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 09 May 2016 (9 years ago) |
| Document Number: | P16000030080 |
| FEI/EIN Number | 812107700 |
| Address: | 408 S 1st Street, Lake Wales, FL, 33853, US |
| Mail Address: | 408 S 1st Street, Lake Wales, FL, 33853, US |
| ZIP code: | 33853 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770930919 | 2016-05-18 | 2016-09-26 | 801 WOODLARK DR, HIGHLAND MEADOWS, HAINES CITY, FL, 338447745, US | 408 S 1ST ST, HIGHLAND MEADOWS, LAKE WALES, FL, 338534146, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 863-676-1710 |
Authorized person
| Name | DR. PRERNA ALFA MALL |
| Role | PRESIDENT |
| Phone | 8636761710 |
Taxonomy
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MALL PRERNA | Agent | 408 S 1st Street, Lake Wales, FL, 33853 |
| Name | Role | Address |
|---|---|---|
| MALL PRERNA | President | 408 S 1st Street, Lake Wales, FL, 33853 |
| Name | Role | Address |
|---|---|---|
| MALL PRERNA | Director | 408 S 1st Street, Lake Wales, FL, 33853 |
| MALL ASIM | Director | 408 S 1st Street, Lake Wales, FL, 33853 |
| Name | Role | Address |
|---|---|---|
| MALL ASIM | Vice President | 408 S 1st Street, Lake Wales, FL, 33853 |
| Name | Role | Address |
|---|---|---|
| MALL ASIM | Treasurer | 408 S 1st Street, Lake Wales, FL, 33853 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-10 | 408 S 1st Street, Lake Wales, FL 33853 | No data |
| CHANGE OF MAILING ADDRESS | 2017-04-10 | 408 S 1st Street, Lake Wales, FL 33853 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-10 | 408 S 1st Street, Lake Wales, FL 33853 | No data |
| AMENDMENT | 2016-05-09 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-03-20 |
| ANNUAL REPORT | 2022-02-09 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-02-20 |
| ANNUAL REPORT | 2018-03-03 |
| ANNUAL REPORT | 2017-04-10 |
| Amendment | 2016-05-09 |
| Domestic Profit | 2016-04-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
