| Entity Name: | UNIVERSITY WALK-IN MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 15 Nov 1999 (25 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P99000100939 |
| FEI/EIN Number | 59-3607609 |
| Address: | 11550 UNIVERSITY BOULEVARD, ORLANDO, FL 32817 |
| Mail Address: | P.O. BOX 781805, ORLANDO, FL 32878 |
| ZIP code: | 32817 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629189410 | 2006-08-31 | 2009-12-10 | 11550 UNIVERSITY BLVD, ORLANDO, FL, 328172100, US | 11550 UNIVERSITY BLVD, ORLANDO, FL, 328172100, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 407-282-2044 |
| Fax | 4076581596 |
Authorized person
| Name | VICTOR YOUNG |
| Role | VICE PRESIDENT |
| Phone | 4072822044 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| License Number | OS8339 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001208900 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | B901V |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CHAO, MAURICE J | Agent | 2549 ROSE SPRING DRIVE, ORLANDO, FL 32825 |
| Name | Role | Address |
|---|---|---|
| CHAO, MAURICE J | Director | 2549 ROSE SPRING DRIVE, ORLANDO, FL 32825 |
| Name | Role | Address |
|---|---|---|
| YOUNG, VICTOR | Manager | 7882 SAILBOAT KEY BLVD # 601, S. PASADENA, FL 33707 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2008-01-09 | 11550 UNIVERSITY BOULEVARD, ORLANDO, FL 32817 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-01-09 | CHAO, MAURICE J | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-01-09 | 2549 ROSE SPRING DRIVE, ORLANDO, FL 32825 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J14000691021 | LAPSED | 1000000616015 | ORANGE | 2014-04-25 | 2024-05-29 | $ 336.36 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1401 W US HIGHWAY 90 STE 100, LAKE CITY FL320556123 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-04-19 |
| ANNUAL REPORT | 2010-02-24 |
| ANNUAL REPORT | 2009-03-24 |
| ANNUAL REPORT | 2008-01-12 |
| ANNUAL REPORT | 2008-01-09 |
| ANNUAL REPORT | 2007-01-14 |
| ANNUAL REPORT | 2006-01-25 |
| ANNUAL REPORT | 2005-01-24 |
| ANNUAL REPORT | 2004-01-11 |
| ANNUAL REPORT | 2003-01-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
