| Entity Name: | HEARTLAND PEDIATRICS OF LAKE WALES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 11 Mar 1997 (28 years ago) |
| Date of dissolution: | 02 Jun 2006 (19 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 02 Jun 2006 (19 years ago) |
| Document Number: | P97000022527 |
| FEI/EIN Number | 65-0737449 |
| Address: | 1356 STATE ROAD 60 E, LAKE WALES, FL 33853 |
| Mail Address: | 1356 STATE ROAD 60 E, LAKE WALES, FL 33853 |
| ZIP code: | 33853 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063433076 | 2006-07-22 | 2020-08-22 | 1356 STATE ROAD 60 E, ORANGE GROVE PLAZA, LAKE WALES, FL, 338534322, US | 1356 STATE ROAD 60 E, ORANGE GROVE PLAZA, LAKE WALES, FL, 338534322, US | |||||||||||||||||
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| Phone | +1 863-679-8888 |
| Fax | 8636762851 |
Authorized person
| Name | DR. RAJESWARI SONNI |
| Role | PRESIDENT MEDICAL DIRECTOR |
| Phone | 8636798888 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| State | FL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| JAMES F. MCCOLLUM, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| SONNI, RAJESWARI | Director | 2523 U.S. 27 SOUTH, SUITE 208, AVON PARK, FL 33825 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2006-06-02 | No data | CONVERSION MEMBER. RESULTING CORPORATION WAS L06000057237. CONVERSION NUMBER 100000057581 |
| CHANGE OF PRINCIPAL ADDRESS | 2001-05-02 | 1356 STATE ROAD 60 E, LAKE WALES, FL 33853 | No data |
| CHANGE OF MAILING ADDRESS | 2001-05-02 | 1356 STATE ROAD 60 E, LAKE WALES, FL 33853 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2006-03-13 |
| ANNUAL REPORT | 2005-04-14 |
| ANNUAL REPORT | 2004-03-08 |
| ANNUAL REPORT | 2003-04-04 |
| ANNUAL REPORT | 2002-03-13 |
| ANNUAL REPORT | 2001-05-02 |
| ANNUAL REPORT | 2000-02-29 |
| ANNUAL REPORT | 1999-04-14 |
| ANNUAL REPORT | 1998-06-22 |
| Domestic Profit Articles | 1997-03-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
