| Entity Name: | PRIMERA CHOICE WALK IN CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 02 Jan 2014 (11 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | L14000000432 |
| Address: | 3861 AVALON PARK EAST BLVD., ORLANDO, FL 32828 |
| Mail Address: | 3861 AVALON PARK EAST BLVD., ORLANDO, FL 32828 |
| ZIP code: | 32828 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346661592 | 2013-12-13 | 2013-12-13 | 3861 AVALON PARK EAST BLVD, ORLANDO, FL, 328284853, US | 3861 AVALON PARK EAST BLVD, ORLANDO, FL, 328284853, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 407-936-4635 |
| Fax | 4075408916 |
Authorized person
| Name | DR. WALTER A BLACK |
| Role | MEDICAL DIRECTOR |
| Phone | 4079364635 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HILL, LISA G | Agent | 3861 AVALON PARK EAST BLVD., ORLANDO, FL 32828 |
| Name | Role | Address |
|---|---|---|
| HILL, LISA G | Authorized Representative | 3861 AVALON PARK EAST BLVD., ORLANDO, FL 32828 |
| Name | Role | Address |
|---|---|---|
| BLACK, WALTER A | Manager | 3861 AVALON PARK EAST BLVD, ORLANDO, FL 32828 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2014-01-02 |
Date of last update: 21 Feb 2025
Sources: Florida Department of State
