| Entity Name: | PREVENTATIVE HEALTHCARE MANAGEMENT, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 23 Jan 2019 (6 years ago) |
| Document Number: | L19000024275 |
| FEI/EIN Number | 83-3468049 |
| Address: | 7342 NW 48 ST, LAUDERHILL, FL 33319 |
| Mail Address: | 7342 NW 48 ST, LAUDERHILL, FL 33319 |
| ZIP code: | 33319 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124586243 | 2019-03-07 | 2019-03-07 | 7342 NW 48TH ST, LAUDERHILL, FL, 333193401, US | 7342 NW 48TH ST, LAUDERHILL, FL, 333193401, US | |||||||||||||
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| Phone | +1 954-471-3500 |
Authorized person
| Name | THEONA A JACKSON |
| Role | PRESIDENT |
| Phone | 9544713500 |
Taxonomy
| Taxonomy Code | 207QA0505X - Adult Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JACKSON, THEONA | Agent | 7342 NW 48 ST, LAUDERHILL, FL 33319 |
| Name | Role | Address |
|---|---|---|
| JACKSON, THEONA | Manager | 7342 NW 48 ST, LAUDERHILL, FL 33319 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000083258 | OPTIMUM BODY REJUVENATION | ACTIVE | 2022-07-13 | 2027-12-31 | No data | 7342 NW 48TH STREET, LAUDERHILL, FL, 33319 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-28 |
| ANNUAL REPORT | 2023-02-28 |
| ANNUAL REPORT | 2022-03-25 |
| ANNUAL REPORT | 2021-02-21 |
| ANNUAL REPORT | 2020-03-19 |
| Florida Limited Liability | 2019-01-23 |
Date of last update: 16 Feb 2025
Sources: Florida Department of State
