| Entity Name: | PRESTIGE HEALTH & WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Sep 2019 (5 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 12 May 2021 (4 years ago) |
| Document Number: | L19000237208 |
| FEI/EIN Number | 873033791 |
| Address: | 1418 Bloomingdale Ave, Valrico, FL, 33596, US |
| Mail Address: | 11334 Village Brook Drive, Riverview, FL, 33579, US |
| ZIP code: | 33596 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811650831 | 2021-10-17 | 2024-01-24 | 10013 WATER WORKS LN, RIVERVIEW, FL, 335785304, US | 1418 BLOOMINGDALE AVE, VALRICO, FL, 335966110, US | |||||||||||||||||||
|
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| Phone | +1 813-967-7075 |
Authorized person
| Name | MS. LOUISANA LOUIS |
| Role | OWNER |
| Phone | 8139677075 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA APRN LICENSE |
| Number | APRN11016727 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Louis Louisana | Agent | 1418 Bloomingdale Ave, VALRICO, FL, 33596 |
| Name | Role | Address |
|---|---|---|
| LOUIS LOUISANA | Manager | 11334 VILLAGE BROOK DR, RIVERVIEW, FL, 33579 |
| Name | Role | Address |
|---|---|---|
| Petilord Ebennsson | Chief Operating Officer | 1418 Bloomingdale Ave, Valrico, FL, 33596 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-31 | 1418 Bloomingdale Ave, VALRICO, FL 33596 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-31 | 1418 Bloomingdale Ave, Valrico, FL 33596 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-18 | 1418 Bloomingdale Ave, Valrico, FL 33596 | No data |
| LC NAME CHANGE | 2021-05-12 | PRESTIGE HEALTH & WELLNESS, LLC | No data |
| LC AMENDMENT | 2020-05-18 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-05-14 | Louis, Louisana | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-31 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-03-10 |
| LC Name Change | 2021-05-12 |
| ANNUAL REPORT | 2021-04-13 |
| LC Amendment | 2020-05-18 |
| ANNUAL REPORT | 2020-05-14 |
| Florida Limited Liability | 2019-09-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
