| Entity Name: | PRIME PHYSICIANS GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 07 Sep 2016 (8 years ago) |
| Date of dissolution: | 30 Apr 2018 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 Apr 2018 (7 years ago) |
| Document Number: | L16000167456 |
| FEI/EIN Number | 81-3809074 |
| Address: | 1860 OLD OKEECHOBEE ROAD, STE 514, WEST PALM BEACH, FL, 33409, US |
| Mail Address: | 1860 OLD OKEECHOBEE ROAD, STE 514, WEST PALM BEACH, FL, 33409, US |
| ZIP code: | 33409 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609324912 | 2016-09-15 | 2017-03-23 | 6600 S. DIXIE HWY, WEST PALM BEACH, FL, 33405, US | 6600 S. DIXIE HWY, WEST PALM BEACH, FL, 33405, US | |||||||||||||||||||||||||||
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| Phone | +1 561-478-2238 |
| Fax | 5616821700 |
Authorized person
| Name | DANIELLE CIRIO |
| Role | OWNER |
| Phone | 5613967321 |
Taxonomy
| Taxonomy Code | 2084A0401X - Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | OS9037 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| License Number | ARNP2573272 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| WILSON CYNTHIA F | Agent | 422 N DIXIE HWY, LAKE WORTH, FL, 33460 |
| Name | Role | Address |
|---|---|---|
| CIRIO DANIELLE | Manager | 1860 OLD OKEECHOBEE ROAD STE 514, WEST PALM BEACH, FL, 33409 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-04-30 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-17 |
| Florida Limited Liability | 2016-09-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
