| Entity Name: | MOTHER DAUGHTER PRIMARY CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Jan 2019 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 30 Jul 2020 (5 years ago) |
| Document Number: | L19000020264 |
| FEI/EIN Number | 833384086 |
| Address: | 10 Fairway Dr, Deerfield Beach, FL, 33441, US |
| Mail Address: | 10 Fairway Dr, Deerfield Beach, FL, 33441, US |
| ZIP code: | 33441 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447715305 | 2019-02-05 | 2024-10-11 | 10 FAIRWAY DR STE 305, DEERFIELD BEACH, FL, 334411802, US | 10 FAIRWAY DR STE 305, DEERFIELD BEACH, FL, 334411802, US | |||||||||||||||
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| Phone | +1 954-744-0020 |
| Fax | 7543186211 |
Authorized person
| Name | MS. ANGELLA JOHN |
| Role | APRN, FNP-BC |
| Phone | 9547440020 |
Taxonomy
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WILSON ROOSEVELT | Agent | 11434 MILLPOND GREENS DRIVE, BOYNTON BEACH, FL, 33473 |
| Name | Role | Address |
|---|---|---|
| WILSON TIFFINY | Manager | 11434 MILLPOND GREENS DRIVE, BOYNTON BEACH, FL, 33473 |
| JOHN ANGELLA | Manager | 6919 W Broward Blvd, Fort Lauderdale, FL, 33317 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000063237 | MDPC HEALTHCARE | ACTIVE | 2024-05-15 | 2029-12-31 | No data | 10 FAIRWAY DR SUITE #305, DEERFIELD BEACH, FL, 33441 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-03 | 10 Fairway Dr, Suite #305, Deerfield Beach, FL 33441 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-03 | 10 Fairway Dr, Suite #305, Deerfield Beach, FL 33441 | No data |
| LC AMENDMENT | 2020-07-30 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-03-29 |
| ANNUAL REPORT | 2022-03-21 |
| ANNUAL REPORT | 2021-04-19 |
| LC Amendment | 2020-07-30 |
| ANNUAL REPORT | 2020-05-22 |
| Florida Limited Liability | 2019-01-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
