Search icon

ADULT MEDICINE OF LAKE COUNTY, INC. - Florida Company Profile

Company claim

Is this your business?

Get access!

Company Details

Entity Name: ADULT MEDICINE OF LAKE COUNTY, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 15 Dec 1997 (28 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 29 Oct 2019 (6 years ago)
Document Number: P97000105435
FEI/EIN Number 593483343
Address: 3619 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757
Mail Address: 3619 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757
ZIP code: 32757
City: Mount Dora
County: Lake
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
NAGEL SHIRLEY M Agent 3619 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757
NAGEL SHIRLEY Dr. President 3619 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757
DAVINA ELEANOR Dr. Vice President 3619 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757

National Provider Identifier

NPI Number:
1851450209
Certification Date:
2024-11-04

Authorized Person:

Name:
SHIRLEY NAGEL
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3523831420

Form 5500 Series

Employer Identification Number (EIN):
593483343
Plan Year:
2023
Number Of Participants:
59
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
47
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
24
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
25
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
20
Sponsors Telephone Number:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G20000092831 MED SPA MOUNT DORA ACTIVE 2020-07-31 2025-12-31 - 3587 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757

Events

Event Type Filed Date Value Description
REINSTATEMENT 2019-10-29 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2019-09-27 - -
REGISTERED AGENT NAME CHANGED 2018-10-31 NAGEL, SHIRLEY MD -
REINSTATEMENT 2018-10-31 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2018-09-28 - -
REGISTERED AGENT ADDRESS CHANGED 2008-01-15 3619 LAKE CENTER DRIVE, MOUNT DORA, FL 32757 -
CHANGE OF PRINCIPAL ADDRESS 2008-01-15 3619 LAKE CENTER DRIVE, MOUNT DORA, FL 32757 -
CHANGE OF MAILING ADDRESS 2008-01-15 3619 LAKE CENTER DRIVE, MOUNT DORA, FL 32757 -

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J22000027005 ACTIVE 35-2021-CA-001989-AXXX-XX CIRCUIT COURT, LAKE COUNTY 2021-10-15 2027-01-18 $168,974.29 BALBOA CAPITAL CORPORATION, 575 ANTON BLVD, 12TH FLOOR, COSTA MESA, CA 92626

Documents

Name Date
ANNUAL REPORT 2025-01-22
ANNUAL REPORT 2024-02-09
ANNUAL REPORT 2023-02-24
ANNUAL REPORT 2022-01-26
ANNUAL REPORT 2021-05-19
ANNUAL REPORT 2020-06-12
REINSTATEMENT 2019-10-29
REINSTATEMENT 2018-10-31
ANNUAL REPORT 2017-02-13
ANNUAL REPORT 2016-03-03

USAspending Awards / Financial Assistance

Date:
2020-04-16
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
325000.00
Total Face Value Of Loan:
325000.00
Date:
2020-04-16
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
325000.00
Total Face Value Of Loan:
325000.00
Date:
2014-04-11
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Obligated Amount:
0.00
Face Value Of Loan:
916400.00
Total Face Value Of Loan:
916400.00

Paycheck Protection Program

Jobs Reported:
46
Initial Approval Amount:
$325,000
Date Approved:
2020-04-16
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$325,000
Race:
Unanswered
Ethnicity:
Hispanic or Latino
Gender:
Female Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$330,556.06
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $270,000
Utilities: $3,500
Mortgage Interest: $6,400
Rent: $26,000
Refinance EIDL: $0
Healthcare: $4000
Debt Interest: $15,100

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 02 Aug 2025

Sources: Florida Department of State