| Entity Name: | LAKESIDE FAMILY MEDICINE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
LAKESIDE FAMILY MEDICINE, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 30 Dec 1997 (27 years ago) |
| Date of dissolution: | 23 Sep 2016 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (9 years ago) |
| Document Number: | P97000108987 |
| FEI/EIN Number |
593484779
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 18550 US HWY 441, MOUNT DORA, FL, 32757, US |
| Mail Address: | 18550 US HWY 441, MOUNT DORA, FL, 32757, US |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679732689 | 2008-06-04 | 2013-03-25 | 4685 N HIGHWAY 19A, MOUNT DORA, FL, 327572039, US | 4685 N HIGHWAY 19A, MOUNT DORA, FL, 327572039, US | |||||||||||||||
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| Phone | +1 352-589-5900 |
| Fax | 3525895904 |
Authorized person
| Name | DR. GERALD EDWARD REYNOLDS |
| Role | PRESIDENT OF LAKESIDE FAMILY MEDICI |
| Phone | 3525895900 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CHANG KHAI | President | 2295 WEATHERED WOOD, LEESBURG, FL, 34748 |
| AUNG MA THUZAR | Treasurer | 2207 AITKIN LOOP, LEESBURG, FL, 34748 |
| CHEEMA SHAHBAZ | Secretary | 1004 PEMBLE RD, LEESBURG, FL, 34748 |
| ZAMAN WAHEEDUZ | Director | 2202 OLD TAVARES RD, LEESBURG, FL, 34748 |
| BHATTARAI BIRENDRA | Director | 31845 SUN PARK CIRCLE, LEESBURG, FL, 34748 |
| BISHT AJAY | Director | 31849 SUN PARK CIRLCE, LEESBURG, FL, 34748 |
| CHANG KHAI | Agent | 18550 US HWY 441, MOUNT DORA, FL, 32757 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | - | - |
| AMENDMENT | 2014-10-03 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2014-10-03 | 18550 US HWY 441, MOUNT DORA, FL 32757 | - |
| CHANGE OF MAILING ADDRESS | 2014-10-03 | 18550 US HWY 441, MOUNT DORA, FL 32757 | - |
| REGISTERED AGENT NAME CHANGED | 2014-10-03 | CHANG, KHAI | - |
| REGISTERED AGENT ADDRESS CHANGED | 2014-10-03 | 18550 US HWY 441, MOUNT DORA, FL 32757 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-03-08 |
| Amendment | 2014-10-03 |
| ANNUAL REPORT | 2014-03-20 |
| ANNUAL REPORT | 2013-04-16 |
| ANNUAL REPORT | 2012-02-13 |
| ANNUAL REPORT | 2011-02-27 |
| ANNUAL REPORT | 2010-02-22 |
| ANNUAL REPORT | 2009-04-02 |
| ANNUAL REPORT | 2008-07-15 |
| ANNUAL REPORT | 2007-02-22 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
