About LAKE SUMTER PODIATRIC MEDICAL ASSOCIATION, INC.
Business Information
| Business Name: | LAKE SUMTER PODIATRIC MEDICAL ASSOCIATION, INC. | ||
|---|---|---|---|
| Document Number: | N19000003000 | FEI/EIN Number: | |
| Filing Type: | Domestic Non-Profit | ||
| Status: | Active | Date Filed: | 03152019 |
| Business Address: | 1807 SALK AVENUE, TAVARES, FL, 32778 | ||
| Mailing Address: | 1807 SALK AVENUE, TAVARES, FL, 32778 | ||
The name and address of the Resident Agent
| Name: | WINN JASON DESQ | ||
|---|---|---|---|
| Name Type: | Person | ||
| Address: | 2709 KILLARNEY WAY, TALLAHASSEE, FL, 32309 | ||
Principals
| Name | Title | Name Type | Address |
|---|---|---|---|
| VILLANI MATTHEW FDPM | PRES | Person | 1807 SALK AVENUE, TAVARES, FL 32778 |
| BLACK JANET DPM | VP | Person | 3651 LAKE CENTER DRIVE, MOUNT DORA, FL 32757 |
| FERGUSON BREANNA DPM | SEC | Person | 3651 LAKE CENTER DRIVE, MOUNT DORA, FL 32757 |
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