| Entity Name: | ZEN MEDICINE IRC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Apr 2019 (6 years ago) |
| Document Number: | L19000115198 |
| FEI/EIN Number | 83-4560150 |
| Address: | 501 PONOKA ST, SEBASTIAN, FL, 32958 |
| Mail Address: | 501 PONOKA ST, SEBASTIAN, FL, 32958 |
| ZIP code: | 32958 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184341083 | 2022-10-21 | 2022-10-21 | 14110 US HIGHWAY 1, SEBASTIAN, FL, 329583233, US | 14110 US HIGHWAY 1, SEBASTIAN, FL, 329583233, US | |||||||||||||||||||||
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| Phone | +1 772-202-2265 |
| Fax | 7723616362 |
Authorized person
| Name | CHRISTINE FESTA |
| Role | OWNER |
| Phone | 7722022265 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1255803649 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Income Tax & More | Agent | 2800 Aurora Rd, Melbourne, FL, 32935 |
| Name | Role | Address |
|---|---|---|
| FESTA CHRISTINE | Authorized Representative | 501 PONOKA ST, SEBASTIAN, FL, 32958 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000131948 | RIVERS EDGE PRIMARY CARE | ACTIVE | 2022-10-21 | 2027-12-31 | No data | 14110 US HWY 1, SEBASTIAN, FL, 32958 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-03-28 | Income Tax & More | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-28 | 2800 Aurora Rd, Suite C, Melbourne, FL 32935 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-22 |
| ANNUAL REPORT | 2023-03-28 |
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-05-25 |
| ANNUAL REPORT | 2020-04-16 |
| Florida Limited Liability | 2019-04-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
