| Entity Name: | DESTINY HEALTH AND WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Mar 2020 (5 years ago) |
| Document Number: | L20000080222 |
| FEI/EIN Number | 85-0528493 |
| Address: | 1070 Montgomery RD, Altamonte Springs, FL, 32714, US |
| Mail Address: | 1070 Montgomery RD, Altamonte Springs, FL, 32714, US |
| ZIP code: | 32714 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104441526 | 2020-06-11 | 2020-06-11 | 14923 NW 7TH AVE, MIAMI, FL, 331683107, US | 14923 NW 7TH AVE, MIAMI, FL, 331683107, US | |||||||||||||||||||
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| Phone | +1 305-685-7669 |
Authorized person
| Name | MARLENE LEBRUN |
| Role | ADMINISTRATOR/CEO |
| Phone | 3056857669 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1043582596 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LEBRUN MARLENE | Agent | 1070 Montgomery RD, Altamonte Springs, FL, 32714 |
| Name | Role | Address |
|---|---|---|
| LEBRUN MARLENE | Manager | 1070 Montgomery RD, Altamonte Springs, FL, 32714 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-30 | 1070 Montgomery RD, #2082, Altamonte Springs, FL 32714 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-30 | 1070 Montgomery RD, #2082, Altamonte Springs, FL 32714 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-04-30 | LEBRUN, MARLENE | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-30 | 1070 Montgomery RD, #2082, Altamonte Springs, FL 32714 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-04-30 |
| Florida Limited Liability | 2020-03-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
