| Entity Name: | LEAVITT MEDICAL ASSOCIATES OF FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Dec 1998 (26 years ago) |
| Document Number: | P98000104471 |
| FEI/EIN Number | 59-3549147 |
| Address: | 151 Southhall Lane, Ste. 300, Maitland, FL, 32751, US |
| Mail Address: | 151 Southhall Lane, Ste. 300, Maitland, FL, 32751, US |
| ZIP code: | 32751 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | LEAVITT MEDICAL ASSOCIATES OF FLORIDA, INC., MISSISSIPPI | 1372134 | MISSISSIPPI |
| Headquarter of | LEAVITT MEDICAL ASSOCIATES OF FLORIDA, INC., ALASKA | 10219076 | ALASKA |
| Headquarter of | LEAVITT MEDICAL ASSOCIATES OF FLORIDA, INC., ALABAMA | 001-056-383 | ALABAMA |
| Headquarter of | LEAVITT MEDICAL ASSOCIATES OF FLORIDA, INC., NEW YORK | 3570463 | NEW YORK |
| Headquarter of | LEAVITT MEDICAL ASSOCIATES OF FLORIDA, INC., KENTUCKY | 1251357 | KENTUCKY |
| Headquarter of | LEAVITT MEDICAL ASSOCIATES OF FLORIDA, INC., CONNECTICUT | 2704444 | CONNECTICUT |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013280635 | 2012-02-13 | 2012-02-13 | 2600 LAKE LUCIEN DR, SUITE 180, MAITLAND, FL, 327517233, US | 8888 SW 136TH ST, 400, MIAMI, FL, 331765883, US | |||||||||||||||||||||
|
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| Phone | +1 407-875-2080 |
| Fax | 4078750515 |
| Phone | +1 305-446-8686 |
Authorized person
| Name | NEFRITA LOGAN |
| Role | PROVIDER SERVICES REP |
| Phone | 4078752080 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| License Number | ME35575 |
| State | FL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Leavitt Matt | President | 151 Southhall Lane, Maitland, FL, 32751 |
| Name | Role | Address |
|---|---|---|
| Leavitt Matt | Director | 151 Southhall Lane, Maitland, FL, 32751 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000017514 | ADVANCED DERMOATOLOGY AND COSMETIC SURGERY | ACTIVE | 2022-02-11 | 2027-12-31 | No data | 151 SOUTHHALL LANE, STE 300, MAITLAND, FL, 32751 |
| G14000017228 | ADVANCED DERMATOLOGY AND COSMETIC SURGERY | ACTIVE | 2014-02-18 | 2029-12-31 | No data | 151 SOUTHHALL LANE, SUITE 300, MAITLAND, FL, 32751 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-09 | 151 Southhall Lane, Ste. 300, Maitland, FL 32751 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-09 | 151 Southhall Lane, Ste. 300, Maitland, FL 32751 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-05-20 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-05-20 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2023-02-26 |
| ANNUAL REPORT | 2022-03-31 |
| Reg. Agent Change | 2021-05-20 |
| ANNUAL REPORT | 2021-04-22 |
| ANNUAL REPORT | 2020-03-04 |
| ANNUAL REPORT | 2019-04-24 |
| Reg. Agent Change | 2019-04-02 |
| ANNUAL REPORT | 2018-03-30 |
| ANNUAL REPORT | 2017-04-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
