| Entity Name: | CUSTOMIZED WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 04 Nov 2010 (14 years ago) |
| Document Number: | L10000114965 |
| FEI/EIN Number | 27-3904578 |
| Address: | 131 W. CENTER AVE., SEBRING, FL 33870 |
| Mail Address: | 131 W. CENTER AVE., SEBRING, FL 33870 |
| ZIP code: | 33870 |
| County: | Highlands |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790335164 | 2019-09-17 | 2019-09-17 | 131 W CENTER AVENUE, SEBRING, FL, 33870, US | 131 W CENTER AVENUE, SEBRING, FL, 33870, US | |||||||||||||||
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| Phone | +1 863-658-1764 |
| Fax | 8558478646 |
Authorized person
| Name | AMANDA C LUCERO |
| Role | OWNER/PROVIDER |
| Phone | 8636581764 |
Taxonomy
| Taxonomy Code | 207VG0400X - Gynecology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WOHL, THOMAS J | Agent | 425 S COMMERCE AVENUE, SEBRING, FL 33870 |
| Name | Role | Address |
|---|---|---|
| LUCERO, AMANDA | Authorized Member | 131 W. CENTER AVE., SEBRING, FL 33870 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-08-30 | 131 W. CENTER AVE., SEBRING, FL 33870 | No data |
| CHANGE OF MAILING ADDRESS | 2019-08-30 | 131 W. CENTER AVE., SEBRING, FL 33870 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-03-09 |
| ANNUAL REPORT | 2022-02-21 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-03-26 |
| AMENDED ANNUAL REPORT | 2019-08-30 |
| ANNUAL REPORT | 2019-02-22 |
| ANNUAL REPORT | 2018-01-26 |
| ANNUAL REPORT | 2017-03-23 |
| ANNUAL REPORT | 2016-02-17 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
