| Entity Name: | LAKE WORTH MEDICAL CLINIC CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 16 Dec 2019 (5 years ago) |
| Last Event: | REVOCATION OF VOLUNTARY DISSOLUT |
| Event Date Filed: | 01 Jul 2021 (4 years ago) |
| Document Number: | P19000094385 |
| FEI/EIN Number | 84-3888622 |
| Address: | 6295 LAKE WORTH RD, STE 30, GREENACRES, FL 33463 |
| Mail Address: | 6295 LAKE WORTH RD, STE 30, GREENACRES, FL 33463 |
| ZIP code: | 33463 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881220861 | 2020-03-21 | 2023-03-28 | 6295 LAKE WORTH RD STE 30, GREENACRES, FL, 334633034, US | 6295 LAKE WORTH RD STE 30, GREENACRES, FL, 334633034, US | |||||||||||||||||
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| Phone | +1 561-660-7399 |
| Fax | 5616607549 |
| Phone | +1 561-377-7006 |
Authorized person
| Name | ROSA MARIA SMITH |
| Role | PRESIDENT |
| Phone | 5616607399 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| LAKE WORTH MEDICAL CLINIC CORP | Agent |
| Name | Role | Address |
|---|---|---|
| Soliman, Sarwat S | President | 6295 LAKE WORTH RD, STE 30 GREENACRES, FL 33463 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REVOCATION OF VOLUNTARY DISSOLUT | 2021-07-01 | No data | No data |
| VOLUNTARY DISSOLUTION | 2021-06-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-04-15 | Lake Worth Medical Clinic Corp | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-07-05 |
| ANNUAL REPORT | 2024-03-18 |
| AMENDED ANNUAL REPORT | 2023-12-06 |
| AMENDED ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2023-04-03 |
| ANNUAL REPORT | 2022-04-27 |
| AMENDED ANNUAL REPORT | 2021-07-28 |
| Revocation of Dissolution | 2021-07-01 |
| VOLUNTARY DISSOLUTION | 2021-06-27 |
| ANNUAL REPORT | 2021-04-15 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3213968200 | 2020-08-04 | 0455 | PPP | 6295 LAKE WORTH RD STE 30, GREENACRES, FL, 33463-2909 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6509618900 | 2021-05-02 | 0455 | PPS | 6295 Lake Worth Rd Ste 30, Greenacres, FL, 33463-3034 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 15 Feb 2025
Sources: Florida Department of State
