| Entity Name: | LIFE MEDICAL CENTER OF LECANTO, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 23 Dec 1997 (27 years ago) |
| Document Number: | P97000107673 |
| FEI/EIN Number | 593483676 |
| Address: | 2611 HWY 44 WEST, INVERNESS, FL, 34453, US |
| Mail Address: | 2611 US HIGHWAY 44 WEST, INVERNESS, FL, 34453, US |
| ZIP code: | 34453 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386613180 | 2006-03-15 | 2011-09-06 | 2611 HIGHWAY 44 W, INVERNESS, FL, 344533725, US | 2611 HIGHWAY 44 W, INVERNESS, FL, 344533725, US | |||||||||||||||||||||||
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| Phone | +1 352-726-0554 |
| Fax | 3527263885 |
Authorized person
| Name | JEFFERY S KINNARD |
| Role | OWNER |
| Phone | 3527260554 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH6693 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS & BLUE SHIELD |
| Number | 38954 |
| Name | Role | Address |
|---|---|---|
| KINNARD JEFFERY S | Agent | 2611 HWY 44 WEST, INVERNESS, FL, 34453 |
| Name | Role | Address |
|---|---|---|
| KINNARD JEFFERY S | Director | 2611 HWY 44 WEST, INVERNESS, FL, 34453 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08217700076 | KINNARD CHIROPRACTIC | ACTIVE | 2008-08-04 | 2028-12-31 | No data | 2611 HWY 44 W, INVERNESS, FL, 34453 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2022-02-01 | 2611 HWY 44 WEST, INVERNESS, FL 34453 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-04-28 | KINNARD, JEFFERY SDR | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-08 | 2611 HWY 44 WEST, INVERNESS, FL 34453 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-04-08 | 2611 HWY 44 WEST, INVERNESS, FL 34453 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-02 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-01-18 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-01-29 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-03-21 |
| ANNUAL REPORT | 2016-03-01 |
| ANNUAL REPORT | 2015-05-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
