| Entity Name: | PREMIER WALK-IN CLINIC & PRIMARY CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Aug 2004 (20 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 23 Aug 2004 (20 years ago) |
| Document Number: | L04000057651 |
| FEI/EIN Number | 201553372 |
| Address: | 5676 S FLORIDA AVENUE, LAKELAND, FL, 33813 |
| Mail Address: | 5408 BURNT HICKORY DRIVE, VALRICO, FL, 33596 |
| ZIP code: | 33813 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033262019 | 2007-01-21 | 2014-10-16 | 5676 S FLORIDA AVE, LAKELAND, FL, 338132526, US | 5676 S FLORIDA AVE, LAKELAND, FL, 338132526, US | |||||||||||||||||||||||||
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| Phone | +1 863-644-3400 |
| Fax | 8636192400 |
Authorized person
| Name | DR. NARINDER S BRAR |
| Role | OWNER |
| Phone | 8636443400 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME65736 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE GROUP PTAN |
| Number | K9032 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BRAR NARINDER S | Agent | 5408 BURNT HICKORY DR, VALRICO, FL, 33596 |
| Name | Role | Address |
|---|---|---|
| BRAR NARINDER S | Managing Member | 5676 S FLORIDA AVENUE, LAKELAND, FL, 33813 |
| BRAR AMRIT | Managing Member | 5676 S FLORIDA AVENUE, LAKELAND, FL, 33813 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G04243900344 | PREMIER WALK - IN CLINIC | ACTIVE | 2004-08-30 | 2029-12-31 | No data | 5676 S FLORIDA AVENUE, LAKELAND, FL, 33813 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2009-03-25 | 5676 S FLORIDA AVENUE, LAKELAND, FL 33813 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-01-17 | BRAR, NARINDER S | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-01-17 | 5408 BURNT HICKORY DR, VALRICO, FL 33596 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-02-15 | 5676 S FLORIDA AVENUE, LAKELAND, FL 33813 | No data |
| NAME CHANGE AMENDMENT | 2004-08-23 | PREMIER WALK-IN CLINIC & PRIMARY CARE LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-14 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-01-16 |
| ANNUAL REPORT | 2020-02-26 |
| ANNUAL REPORT | 2019-02-19 |
| ANNUAL REPORT | 2018-02-13 |
| ANNUAL REPORT | 2017-03-27 |
| ANNUAL REPORT | 2016-02-01 |
| ANNUAL REPORT | 2015-01-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
