| Entity Name: | BENJAMIN E. LIPPMANN, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Apr 2016 (9 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 16 Sep 2021 (3 years ago) |
| Document Number: | P16000034192 |
| FEI/EIN Number | 81-2565888 |
| Address: | 5302 FLORIDA AVENUE SOUTH, SUITE 206, LAKELAND, FL, 33813, US |
| Mail Address: | 5302 FLORIDA AVENUE SOUTH, SUITE 206, LAKELAND, FL, 33813, US |
| ZIP code: | 33813 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407500390 | 2022-02-09 | 2022-02-09 | 5302 S FLORIDA AVE STE 206, LAKELAND, FL, 338134910, US | 5302 S FLORIDA AVE STE 206, LAKELAND, FL, 338134910, US | |||||||||||||
|
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| Phone | +1 863-289-0968 |
Authorized person
| Name | DR. BENJAMIN ELLIOT LIPPMANN |
| Role | CEO |
| Phone | 8632890968 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| BLALOCK WALTERS, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| Lippmann Benjamin EDr. | Chief Executive Officer | 4512 BROOKSHIRE PL, LAKE WALES, FL, 33898 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-11-07 | 5302 FLORIDA AVENUE SOUTH, SUITE 206, LAKELAND, FL 33813 | No data |
| CHANGE OF MAILING ADDRESS | 2024-11-07 | 5302 FLORIDA AVENUE SOUTH, SUITE 206, LAKELAND, FL 33813 | No data |
| REINSTATEMENT | 2021-09-16 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-09-16 | BLALOCK WALTERS, P.A. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-09-16 | 802 11TH STREET WEST, BRADENTON, FL 34205 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-03-13 |
| ANNUAL REPORT | 2022-04-14 |
| REINSTATEMENT | 2021-09-16 |
| ANNUAL REPORT | 2019-04-05 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-01-10 |
| Domestic Profit | 2016-04-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
