| Entity Name: | PRIME CARE MEDICAL CENTERS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 08 Jan 2016 (9 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L16000006170 |
| FEI/EIN Number | 81-1011785 |
| Address: | 1400 HAVENDALE BLVD. # 3, WINTER HAVEN, FL 33881 |
| Mail Address: | 1400 HAVENDALE BLVD. # 3, WINTER HAVEN, FL 33881 |
| ZIP code: | 33881 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336508449 | 2016-02-17 | 2016-08-17 | 1400 HAVENDALE BLVD NW STE 3, WINTER HAVEN, FL, 338815302, US | 1400 HAVENDALE BLVD NW STE 3, WINTER HAVEN, FL, 338815302, US | |||||||||||||||||||||||
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| Phone | +1 863-294-3109 |
| Fax | 8632930078 |
Authorized person
| Name | DAVID R THOMSEN |
| Role | OWNER |
| Phone | 8632943109 |
Taxonomy
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| TUCKER, JOHN R, III | Agent | 1400 HAVENDALE BLVD. # 3, WINTER HAVEN, FL 33881 |
| Name | Role | Address |
|---|---|---|
| TUCKER, JOHN R | Manager | 1400 HAVENDALE BLVD., SUITE 3, WINTER HAVEN, FL 33881 |
| THOMSEN, DAVID R | Manager | 1400 HAVENDALE BLVD., SUITE 3, WINTER HAVEN, FL 33881 |
| Name | Role | Address |
|---|---|---|
| THOMSEN, DAVID R | Authorized Member | 1400 HAVENDALE BLVD., SUITE 3, WINTER HAVEN, FL 33881 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-02-17 | 1400 HAVENDALE BLVD. # 3, WINTER HAVEN, FL 33881 | No data |
| CHANGE OF MAILING ADDRESS | 2017-02-17 | 1400 HAVENDALE BLVD. # 3, WINTER HAVEN, FL 33881 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-02-17 | 1400 HAVENDALE BLVD. # 3, WINTER HAVEN, FL 33881 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-02-17 |
| Florida Limited Liability | 2016-01-08 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
