| Entity Name: | TOTAL FOOT CARE AND WELLNESS CLINIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Nov 2015 (9 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 08 Jun 2020 (5 years ago) |
| Document Number: | L15000195740 |
| FEI/EIN Number | 81-0687502 |
| Address: | 8021 Philips Hwy Suite 1, JACKSONVILLE, FL, 32256, US |
| Mail Address: | 8021 Philips Hwy Suite 1, JACKSONVILLE, FL, 32256, US |
| ZIP code: | 32256 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578938684 | 2015-12-01 | 2024-03-20 | 8021 PHILIPS HWY STE 1, JACKSONVILLE, FL, 322567460, US | 8021 PHILIPS HWY STE 1, JACKSONVILLE, FL, 322567460, US | |||||||||||||||||||||||||
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| Phone | +1 904-323-0954 |
| Fax | 9046602125 |
Authorized person
| Name | CANDICE L KENNEDY |
| Role | OWNER |
| Phone | 9043230954 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 020165000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KENNEDY CANDICE | Agent | 8021 Philips Hwy Suite 1, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| KENNEDY CANDICE | Authorized Member | 8021 Philips Hwy Suite 1, JACKSONVILLE, FL, 32256 |
| KENNEDY ALVIN PJR | Authorized Member | 8021 Philips Hwy Suite 1, JACKSONVILLE, FL, 32256 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-10-11 | 8021 Philips Hwy Suite 1, JACKSONVILLE, FL 32256 | No data |
| CHANGE OF MAILING ADDRESS | 2021-10-11 | 8021 Philips Hwy Suite 1, JACKSONVILLE, FL 32256 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-10-11 | 8021 Philips Hwy Suite 1, JACKSONVILLE, FL 32256 | No data |
| LC AMENDMENT | 2020-06-08 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-04-30 | KENNEDY , CANDICE | No data |
| REINSTATEMENT | 2016-11-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-22 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-15 |
| AMENDED ANNUAL REPORT | 2021-10-11 |
| ANNUAL REPORT | 2021-04-23 |
| ANNUAL REPORT | 2020-06-30 |
| LC Amendment | 2020-06-08 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
