| Entity Name: | PRIMARY CARE ASSOCIATES OF FLORIDA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 May 2007 (18 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 10 Oct 2020 (4 years ago) |
| Document Number: | L07000049465 |
| FEI/EIN Number | 412240188 |
| Address: | 83 Geneva Dr., Att: 622393, Oviedo, FL, 32765-2393, US |
| Mail Address: | 2528 WILLOW DROP WAY, OVIEDO, FL, 32766, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659571404 | 2007-07-20 | 2012-11-21 | 1403 MEDICAL PLAZA DR, SUITE 107, SANFORD, FL, 327711000, US | 1403 MEDICAL PLAZA DR, SUITE 107, SANFORD, FL, 327711000, US | |||||||||||||||||||||||||
|
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| Phone | +1 407-321-8801 |
| Fax | 4073217648 |
Authorized person
| Name | DR. ALEXANDRA ALEXIS |
| Role | PHYSICIAN |
| Phone | 4073218801 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME94804 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 275187900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ALEXIS ALEXANDRA | Agent | 2528 WILLOW DROP WAY, OVIEDO, FL, 32766 |
| Name | Role | Address |
|---|---|---|
| ALEXIS ALEXANDRA | Managing Member | 2528 WILLOW DROP WAY, OVIEDO, FL, 32766 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-11 | 2528 Willow Drop Way, Oviedo, FL 32765-2393 | No data |
| REINSTATEMENT | 2020-10-10 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-10-10 | 83 Geneva Dr., Att: 622393, Oviedo, FL 32765-2393 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-10-10 | ALEXIS, ALEXANDRA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-10-10 | 2528 WILLOW DROP WAY, OVIEDO, FL 32766 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| LC AMENDMENT | 2012-04-26 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-10 | 83 Geneva Dr., Att: 622393, Oviedo, FL 32765-2393 | No data |
| LC AMENDMENT | 2008-10-08 | No data | No data |
| CANCEL ADM DISS/REV | 2008-09-29 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-11 |
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-03-24 |
| ANNUAL REPORT | 2022-04-14 |
| ANNUAL REPORT | 2021-03-05 |
| REINSTATEMENT | 2020-10-10 |
| ANNUAL REPORT | 2019-02-28 |
| ANNUAL REPORT | 2018-04-15 |
| ANNUAL REPORT | 2017-03-24 |
| ANNUAL REPORT | 2016-04-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
