| Entity Name: | PLATINUM WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Dec 2016 (8 years ago) |
| Document Number: | L16000221411 |
| FEI/EIN Number | 81-4636841 |
| Address: | 1213 PIPER BOULEVARD, NAPLES, FL, 34110 |
| Mail Address: | 1213 PIPER BOULEVARD, NAPLES, FL, 34110 |
| ZIP code: | 34110 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265173157 | 2022-04-05 | 2022-04-06 | 1213 PIPER BLVD, NAPLES, FL, 341101393, US | 1213 PIPER BLVD, NAPLES, FL, 341101393, US | |||||||||||||||||||||
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| Phone | +1 239-254-0099 |
| Fax | 2392541908 |
Authorized person
| Name | KRYSTINE SWANNICK-KONOPCZYNSKI |
| Role | PRACTICE OWNER |
| Phone | 2392540099 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 275067800 |
| State | FL |
| Name | Role |
|---|---|
| ACME AGENT FLORIDA LLC | Agent |
| Name | Role | Address |
|---|---|---|
| GADALLAH MERIT DR. | Manager | 1213 PIPER BOULEVARD, NAPLES, FL, 34110 |
| SWANNICK KRYSTINE DR. | Manager | 1213 PIPER BOULEVARD, NAPLES, FL, 34110 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2019-04-22 | Acme Agent Florida LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| ANNUAL REPORT | 2023-04-16 |
| ANNUAL REPORT | 2022-02-27 |
| ANNUAL REPORT | 2021-02-19 |
| ANNUAL REPORT | 2020-03-11 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-04-25 |
| Florida Limited Liability | 2016-12-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
