| Entity Name: | GERIATRX HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 15 Oct 2018 (6 years ago) |
| Document Number: | L18000237035 |
| FEI/EIN Number | N/A |
| Address: | 5753 SW LONGSPUR LN, PALM CITY, FL 34990 |
| Mail Address: | 5753 SW LONGSPUR LN, PALM CITY, FL 34990 |
| ZIP code: | 34990 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881150142 | 2019-02-12 | 2019-02-12 | PO BOX 8689, JUPITER, FL, 334688689, US | 5753 SW LONGSPUR LN, PALM CITY, FL, 349908839, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 561-748-2889 |
| Phone | +1 772-260-6922 |
Authorized person
| Name | KAREN BARLOW |
| Role | ADMINISTRATOR |
| Phone | 5617482889 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PENDING |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LEVENSTEIN, RICHARD H | Agent | 3001 PGA BLVD STE 305, PALM BEACH GARDENS, FL 33410 |
| Name | Role | Address |
|---|---|---|
| GIL, WALTER | Manager | 5753 SW LONGSPUR LN, PALM CITY, FL 34990 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000119193 | PREMIUM HEALTH & REJUVENATION | ACTIVE | 2022-09-20 | 2027-12-31 | No data | 5753 SW LONGSPUR LANE, PALM CITY, FL, 34990 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-05 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-06-24 |
| Florida Limited Liability | 2018-10-15 |
Date of last update: 17 Jan 2025
Sources: Florida Department of State
