| Entity Name: | MID-FLORIDA ENDODONTICS-MT DORA, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 07 Mar 2023 (2 years ago) |
| Date of dissolution: | 04 Dec 2024 (2 months ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 04 Dec 2024 (2 months ago) |
| Document Number: | P23000017553 |
| FEI/EIN Number | 92-3633351 |
| Address: | 2855 W STATE RD 434, SUITE 1021, LONGWOOD, FL, 32779, US |
| Mail Address: | 2855 W STATE RD 434, SUITE 1021, LONGWOOD, FL, 32779, US |
| ZIP code: | 32779 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114750890 | 2024-08-20 | 2024-08-20 | 2855 W STATE ROAD 434 STE 1021, LONGWOOD, FL, 327794480, US | 18660 US HIGHWAY 441 STE 104, MOUNT DORA, FL, 327576731, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 407-788-8880 |
Authorized person
| Name | ALEC DAVID DU LAC |
| Role | OFFICE ADMIN |
| Phone | 4077888880 |
Taxonomy
| Taxonomy Code | 1223E0200X - Endodontist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LIPKIN BRAD | Agent | 2855 W STATE RD 434, SUITE 1021, LONGWOOD, FL, 32779 |
| Name | Role | Address |
|---|---|---|
| LIPKIN BRAD | President | 2855 W STATE RD 434, SUITE 1021, LONGWOOD, FL, 32779 |
| Name | Role | Address |
|---|---|---|
| ISLER AARON | Vice President | 2855 W STATE RD 434, SUITE 1021, LONGWOOD, FL, 32779 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000103817 | MIDFLORIDA ENDODONTICS | ACTIVE | 2019-09-24 | 2029-12-31 | No data | 2855 W STATE ROAD 434, SUITE 1021, LONGWOOD, FL, 32779 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2024-12-04 | No data | CONVERSION MEMBER. RESULTING CORPORATION WAS L24000513302. CONVERSION NUMBER 900000261739 |
| NAME CHANGE AMENDMENT | 2023-05-17 | MID-FLORIDA ENDODONTICS-MT DORA, P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-12 |
| Name Change | 2023-05-17 |
| Domestic Profit | 2023-03-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
