| Entity Name: | PRIMACARE HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Jul 2017 (8 years ago) |
| Document Number: | L17000157090 |
| FEI/EIN Number | 82-2267170 |
| Address: | 5800 49th Street N,, St. Petersburg, FL, 33709, US |
| Mail Address: | 5800 49th Street N,, St. Petersburg, FL, 33709, US |
| ZIP code: | 33709 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811749062 | 2024-04-02 | 2024-04-02 | 5800 49TH AVE N STE S103, KENNETH CITY, FL, 337093563, US | 5800 49TH AVE N STE S103, KENNETH CITY, FL, 337093563, US | |||||||||||||||||||||
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| Phone | +1 727-823-4848 |
| Fax | 7278234880 |
Authorized person
| Name | TRACY HAUGHTON |
| Role | OFFICE MANAGER |
| Phone | 7278234848 |
Taxonomy
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1528064797 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WHEELER JOHN L | Agent | 10777 - 96TH STREET N, LARGO, FL, 33773 |
| Name | Role | Address |
|---|---|---|
| WHEELER JOHN L | Manager | 10777 - 96TH STREET N, LARGO, FL, 33773 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-12-05 | 5800 49th Street N,, Suite S-103, St. Petersburg, FL 33709 | No data |
| CHANGE OF MAILING ADDRESS | 2023-12-05 | 5800 49th Street N,, Suite S-103, St. Petersburg, FL 33709 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| AMENDED ANNUAL REPORT | 2023-12-05 |
| ANNUAL REPORT | 2023-02-18 |
| ANNUAL REPORT | 2022-03-06 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-04-13 |
| ANNUAL REPORT | 2019-04-04 |
| ANNUAL REPORT | 2018-03-29 |
| Florida Limited Liability | 2017-07-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
