| Entity Name: | INNOVATIVE PRIMARY CARE PLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 Sep 2011 (13 years ago) |
| Document Number: | L11000106351 |
| FEI/EIN Number | 45-3275749 |
| Mail Address: | 2880 David Walker Drive, Suite 129, Eustis, FL 32726 |
| Address: | 901 N. Grove Street, Eustis, FL 32726 |
| ZIP code: | 32726 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346524956 | 2011-09-30 | 2023-02-22 | 901 N GROVE ST, EUSTIS, FL, 327262805, US | 901 N GROVE ST, EUSTIS, FL, 327262805, US | |||||||||||||||||||
|
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| Phone | +1 352-508-7040 |
Authorized person
| Name | DR. AJIT VALLABHDAS HANSALIA |
| Role | MEMBER |
| Phone | 3526386493 |
Taxonomy
| Taxonomy Code | 207RH0002X - Hospice and Palliative Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | DRIVER LICENSE |
| Number | H524018710510 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HANSALIA, AJIT V | Agent | 901 N. Grove Street, Eustis, FL 32726 |
| Name | Role | Address |
|---|---|---|
| HANSALIA, AJIT V | President | 901 N. Grove Street, Eustis, FL 32726 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000110523 | LAKE PALLIATIVE CARE PROVIDERS | ACTIVE | 2018-10-11 | 2028-12-31 | No data | 2880 DAVID WALKER DRIVE, SUITE 129, EUSTIS, FL, 32726 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-12 | 901 N. Grove Street, Eustis, FL 32726 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-12 | 901 N. Grove Street, Eustis, FL 32726 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-12 | 901 N. Grove Street, Eustis, FL 32726 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-16 |
| ANNUAL REPORT | 2023-04-03 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-02-21 |
| ANNUAL REPORT | 2020-02-13 |
| ANNUAL REPORT | 2019-03-31 |
| ANNUAL REPORT | 2018-02-23 |
| ANNUAL REPORT | 2017-04-06 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-07 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
