| Entity Name: | DIVINE DESTINY VIRTUAL HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 22 May 2020 (5 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L20000140152 |
| FEI/EIN Number | 851245282 |
| Address: | 2631-A NW 41ST STREET, GAINESVILLE, FL, 32606, US |
| Mail Address: | 2631-A NW 41ST STREET, GAINESVILLE, FL, 32606, US |
| ZIP code: | 32606 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235756313 | 2020-07-06 | 2023-11-27 | 2631A NW 41ST ST, GAINESVILLE, FL, 326066628, US | 2631A NW 41ST ST, GAINESVILLE, FL, 326066628, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-732-0720 |
| Fax | 8556040918 |
| Phone | +1 407-732-2070 |
Authorized person
| Name | LOUELLA PRITCHETTE |
| Role | OWNER |
| Phone | 4077320720 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | COMMERCIAL |
| Number | 1104161017 |
| State | PA |
| Issuer | COMMERCIAL |
| Number | 1104161017 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1104161017 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1104161017 |
| State | PA |
| Name | Role | Address |
|---|---|---|
| ACCOUNTANTS AND BUSINESS ADVISORS, LLC | Agent | 2631-A NW 41ST STREET, GAINESVILLE, FL, 32606 |
| Name | Role | Address |
|---|---|---|
| PRITCHETTE LOUELLA DO | Chief Executive Officer | 2631-A NW 41ST STREET, GAINESVILLE, FL, 32606 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| LC AMENDMENT | 2020-10-26 | No data | No data |
| LC AMENDMENT | 2020-06-08 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-11 |
| LC Amendment | 2020-10-26 |
| LC Amendment | 2020-06-08 |
| Florida Limited Liability | 2020-05-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
