| Entity Name: | CARE ONE OF FLORIDA L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Aug 2005 (19 years ago) |
| Document Number: | L05000083937 |
| FEI/EIN Number | 251924516 |
| Address: | 12220 CORTEZ BLVD, BROOKSVILLE, FL, 34613 |
| Mail Address: | 12220 CORTEZ BLVD, BROOKSVILLE, FL, 34613 |
| ZIP code: | 34613 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932875796 | 2021-08-20 | 2021-08-20 | 12220 CORTEZ BLVD, BROOKSVILLE, FL, 346132631, US | 10435 US HIGHWAY 19, PORT RICHEY, FL, 346683133, US | |||||||||||||||||||||||
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| Phone | +1 352-432-0817 |
| Phone | +1 727-378-4477 |
| Fax | 7273787755 |
Authorized person
| Name | STACIE S LAVIANO |
| Role | MANAGING MEMBER |
| Phone | 3524320817 |
Taxonomy
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 307544303 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LAVIANO STACIE | Agent | 12220 CORTEZ BLVD, BROOKSVILLE, FL, 34613 |
| Name | Role | Address |
|---|---|---|
| LAVIANO ANTHONY | Managing Member | 13047 FELLOWSHIP LANE, WEEKI WACHEE, FL, 34614 |
| LAVIANO STACIE | Managing Member | 13047 FELLOWSHIP LANE, WEEKI WACHEE, FL, 34614 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-06 | 12220 CORTEZ BLVD, BROOKSVILLE, FL 34613 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-03-26 | 12220 CORTEZ BLVD, BROOKSVILLE, FL 34613 | No data |
| CHANGE OF MAILING ADDRESS | 2012-03-26 | 12220 CORTEZ BLVD, BROOKSVILLE, FL 34613 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-06 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-02-28 |
| ANNUAL REPORT | 2021-02-15 |
| ANNUAL REPORT | 2020-02-21 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-04-18 |
| ANNUAL REPORT | 2017-04-13 |
| ANNUAL REPORT | 2016-03-18 |
| ANNUAL REPORT | 2015-02-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
