| Entity Name: | PRIMARY CARE & FUNCTIONAL MEDICINE CONSULTANTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Oct 2019 (5 years ago) |
| Last Event: | LC AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 11 Aug 2022 (2 years ago) |
| Document Number: | L19000259705 |
| FEI/EIN Number | 84-3518970 |
| Address: | 508 AIRPORT RD, PANAMA CITY, FL, 32405, US |
| Mail Address: | 508 Airport Rd, Suite D, Panama City, FL, 32405, US |
| ZIP code: | 32405 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598487050 | 2022-09-13 | 2023-02-17 | 508 AIRPORT RD STE D, PANAMA CITY, FL, 324054025, US | 508 AIRPORT RD STE D, PANAMA CITY, FL, 324054025, US | |||||||||||||||||||||||||
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| Phone | +1 850-215-5830 |
| Fax | 8503537006 |
| Phone | +1 850-890-5559 |
Authorized person
| Name | YESENIA RAMOS |
| Role | NURSE PRACTITIONER |
| Phone | 8502155830 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 364SA2200X - Adult Health Clinical Nurse Specialist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RAMOS YESENIA | Agent | 231 JOHNSON BAYOU DRIVE, PANAMA CITY BEACH, FL, 32407 |
| Name | Role | Address |
|---|---|---|
| RAMOS YESENIA | Manager | 231 JOHNSON BAYOU DRIVE, PANAMA CITY BEACH, FL, 32407 |
| GALANOPLOS GEORGE | Manager | 231 JOHNSON BAYOU DRIVE, PANAMA CITY BEACH, FL, 32407 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-29 | 508 AIRPORT RD, SUITE D, PANAMA CITY, FL 32405 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-29 | 508 AIRPORT RD, SUITE D, PANAMA CITY, FL 32405 | No data |
| LC AMENDMENT AND NAME CHANGE | 2022-08-11 | PRIMARY CARE & FUNCTIONAL MEDICINE CONSULTANTS, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-04 | 231 JOHNSON BAYOU DRIVE, PANAMA CITY BEACH, FL 32407 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-29 |
| ANNUAL REPORT | 2023-02-10 |
| LC Amendment and Name Change | 2022-08-11 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-03-04 |
| Florida Limited Liability | 2019-10-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
