| Entity Name: | HEALTHWISE MEDICAL PRACTICE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 May 2018 (7 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 03 Oct 2023 (a year ago) |
| Document Number: | L18000119302 |
| FEI/EIN Number | 83-0858039 |
| Address: | 1415 COLONIAL BLVD, UNIT 1, FORT MYERS, FLORIDA, FL, 33907, US |
| Mail Address: | 1415 Colonial Blvd, Fort Myers, FL, 33907, US |
| ZIP code: | 33907 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821573684 | 2018-09-27 | 2018-09-27 | 8140 LIRIOPE LOOP, LEHIGH ACRES, FL, 339727546, US | 1415 COLONIAL BLVD, FORT MYERS, FL, 339071043, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 646-267-6718 |
| Phone | +1 239-202-4517 |
Authorized person
| Name | JESSIE MARTIN |
| Role | PHYSICIAN |
| Phone | 6462676718 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MARTIN JESSIE M.D | Agent | 1415 Colonial Blvd, Fort Myers, FL, 33907 |
| Name | Role | Address |
|---|---|---|
| MARTIN JESSIE M.D | Manager | 1415 COLONIAL BLVD, FORT MYERS, FLORIDA, AL, 33907 |
| Name | Role | Address |
|---|---|---|
| EMMANUEL PEREIRA PH.D | Authorized Member | 1415 COLONIAL BLVD, FORT MYERS,, FL, 33907 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2023-10-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-11-04 | MARTIN, JESSIE, M.D | No data |
| REINSTATEMENT | 2020-11-04 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-30 | 1415 Colonial Blvd, Suite 1, Fort Myers, FL 33907 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-30 | 1415 COLONIAL BLVD, UNIT 1, FORT MYERS, FLORIDA, FL 33907 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-30 | 1415 COLONIAL BLVD, UNIT 1, FORT MYERS, FLORIDA, FL 33907 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| REINSTATEMENT | 2023-10-03 |
| ANNUAL REPORT | 2022-03-22 |
| ANNUAL REPORT | 2021-04-15 |
| REINSTATEMENT | 2020-11-04 |
| ANNUAL REPORT | 2019-04-30 |
| Florida Limited Liability | 2018-05-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
