| Entity Name: | AFFORDABLE PRIMARY CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 27 Nov 2012 (12 years ago) |
| Document Number: | L12000148294 |
| FEI/EIN Number | 82-3562270 |
| Address: | 3755 w old us hwy 441, mt dora, FL 32757 |
| Mail Address: | 3755 w old us hwy 441, mt dora, FL 32757 |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659888394 | 2018-01-03 | 2024-03-04 | 1840 CLASSIQUE LN, TAVARES, FL, 327785748, US | 1840 CLASSIQUE LN, TAVARES, FL, 327785748, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 352-483-3730 |
| Fax | 3525089661 |
Authorized person
| Name | WENDY SHARON PERROTT |
| Role | PHYSICIAN |
| Phone | 3524833730 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0066695 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 375664500 |
| State | FL |
| Issuer | DEA |
| Number | FP2223698 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| seidman, marvin b | Agent | 3755 w old us hwy 441, mt dora, FL 32757 |
| Name | Role | Address |
|---|---|---|
| audain, fed, RN | Manager | 3755 w old us hwy 441, mt dora, FL 32757 |
| Name | Role | Address |
|---|---|---|
| desarme, suzelle K | Authorized Representative | 3755 w old us hwy 441, mt dora, FL 32757 |
| Name | Role |
|---|---|
| HEALTHY CHOICE MEDICAL, LLC | Authorized Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000102377 | HEALTHY CHOICE MEDICAL | ACTIVE | 2023-08-30 | 2028-12-31 | No data | 3755 W OLD US HWY 441, MT DORA, FL, 32757 |
| G18000000605 | HEALTHY CHOICE OB-GYN | EXPIRED | 2018-01-02 | 2023-12-31 | No data | 2146 VINDALE RD, TAVARES, FL, 32778 |
| G15000069982 | WOMEN'S HEALTH PAVILLION | EXPIRED | 2015-07-06 | 2020-12-31 | No data | 501 W BADGER AVE, EUSTIS, FL, 32726 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-08 | 3755 w old us hwy 441, mt dora, FL 32757 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-08 | 3755 w old us hwy 441, mt dora, FL 32757 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-08 | 3755 w old us hwy 441, mt dora, FL 32757 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-04-14 | seidman, marvin b | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-12 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-23 |
| ANNUAL REPORT | 2020-06-03 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-02-05 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-04-26 |
| ANNUAL REPORT | 2015-04-14 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
