| Entity Name: | CORNERSTONE PRIMARY CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Feb 2020 (5 years ago) |
| Document Number: | L20000057991 |
| FEI/EIN Number | 84-4802858 |
| Mail Address: | 12470 TELECOM DRIVE, SUITE 301, ATTN: LEGAL, TEMPLE TERRACE, FL, 33637, US |
| Address: | 2445 LANE PARK ROAD, TAVARES, FL, 32778, US |
| ZIP code: | 32778 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386278828 | 2020-02-24 | 2020-12-30 | 2445 LANE PARK RD, TAVARES, FL, 327789648, US | 2445 LANE PARK RD, TAVARES, FL, 327789648, US | |||||||||||||||
|
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| Phone | +1 352-343-1341 |
| Fax | 3523436115 |
Authorized person
| Name | CHARLES LEE |
| Role | MANAGER/CEO |
| Phone | 3523431341 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MOLOSKY ANDREW K | Agent | 12470 TELECOM DRIVE, SUITE 301, TEMPLE TERRACE, FL, 33637 |
| Name | Role |
|---|---|
| CORNERSTONE HEALTH SERVICES, INC. | Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-04-28 | 2445 LANE PARK ROAD, TAVARES, FL 32778 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-28 | MOLOSKY, ANDREW K | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-28 | 12470 TELECOM DRIVE, SUITE 301, ATTN: LEGAL, TEMPLE TERRACE, FL 33637 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-22 |
| ANNUAL REPORT | 2021-03-04 |
| Florida Limited Liability | 2020-02-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
