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DESTIN PRIMARY CARE, LLC

Company Details

Entity Name: DESTIN PRIMARY CARE, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Inactive
Date Filed: 14 Jun 2006 (19 years ago)
Date of dissolution: 30 Dec 2010 (14 years ago)
Last Event: LC VOLUNTARY DISSOLUTION
Event Date Filed: 30 Dec 2010 (14 years ago)
Document Number: L06000060955
FEI/EIN Number 22-3935210
Address: ONE PARK PLAZA, NASHVILLE, TN 37203
Mail Address: ONE PARK PLAZA, NASHVILLE, TN 37203
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1275601023 2006-12-01 2020-08-22 996 AIRPORT RD, DESTIN, FL, 325412824, US 996 AIRPORT RD, SUITE E 103, DESTIN, FL, 325412824, US

Contacts

Phone +1 850-837-5562
Fax 8508376085

Authorized person

Name JO LUCIDO
Role OFFICE MANAGER
Phone 8508375562

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

Manager

Name Role Address
MOORE, A BRUCE JR Manager ONE PARK PLAZA, NASHVILLE, TN 37203
JOHNSON, R. MILTON Manager ONE PARK PLAZA, NASHVILLE, TN 37203
RUTHERFORD, WILLIAM B Manager ONE PARK PLAZA, NASHVILLE, TN 37203

Events

Event Type Filed Date Value Description
LC VOLUNTARY DISSOLUTION 2010-12-30 No data No data

Documents

Name Date
LC Voluntary Dissolution 2010-12-30
ANNUAL REPORT 2010-04-22
ANNUAL REPORT 2009-03-30
ANNUAL REPORT 2008-04-16
ANNUAL REPORT 2007-05-01
Florida Limited Liability 2006-06-14

Date of last update: 03 Jan 2025

Sources: Florida Department of State