| Entity Name: | WOUND AND MEDICAL OUTREACH CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 17 Feb 2020 (5 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | L20000053861 |
| Address: | ADMIN 12250 BLUE PACIFIC DRIVE, RIVERVIEW, FL, 33579, UN |
| Mail Address: | ADMIN 12250 BLUE PACIFIC DRIVE, RIVERVIEW, FL, 33579, UN |
| ZIP code: | 33579 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881229532 | 2020-03-03 | 2023-11-27 | 12250 BLUE PACIFIC DR, RIVERVIEW, FL, 335791803, US | 12250 BLUE PACIFIC DR, RIVERVIEW, FL, 335791803, US | |||||||||||||||||||||||||||||||
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| Fax | 8003512611 |
| Phone | +1 813-777-1591 |
Authorized person
| Name | JILL M MARSHALL ALLEN |
| Role | MGMR |
| Phone | 8137771591 |
Taxonomy
| Taxonomy Code | 163WW0000X - Wound Care Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MARSHALL-ALLEN JILL | Agent | 12250 BLUE PACIFIC DRIVE, RIVERVIEW, FL, 33579 |
| Name | Role | Address |
|---|---|---|
| MARSHALL-ALLEN JILL | Manager | ADMIN:12250 BLUE PACIFIC DRIVE, RIVERVIEW, FL, 33579 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
