| Entity Name: | FAMILY MEDICAL CLINIC AND WELLNESS "LLC" |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 May 2020 (5 years ago) |
| Last Event: | LC AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 08 Mar 2023 (2 years ago) |
| Document Number: | L20000146738 |
| FEI/EIN Number | 85-1259454 |
| Address: | 7736 Greenbrier cir, Port St Lucie, FL, 34986, US |
| Mail Address: | 7736 Greenbrier cir, Port St Lucie, FL, 34986, US |
| ZIP code: | 34986 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801676556 | 2023-10-02 | 2023-10-02 | 7736 GREENBRIER CIR, PORT SAINT LUCIE, FL, 349863301, US | 207 NW SAINT JAMES DR, PORT SAINT LUCIE, FL, 349831291, US | |||||||||||||||
|
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| Phone | +1 561-714-7432 |
| Phone | +1 772-710-8583 |
Authorized person
| Name | DR. TERESA A KOWALCZYK VITOUS |
| Role | OWNER |
| Phone | 5617147432 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VITOUS TERESA | Agent | 7736 Greenbrier cir, Port St Lucie, FL, 34986 |
| Name | Role | Address |
|---|---|---|
| VITOUS TERESA Dr. | Chief Executive Officer | 7736 Greenbrier cir, Port St Lucie, FL, 34986 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT AND NAME CHANGE | 2023-03-08 | FAMILY MEDICAL CLINIC AND WELLNESS "LLC" | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-02 | 7736 Greenbrier cir, Port St Lucie, FL 34986 | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-02 | 7736 Greenbrier cir, Port St Lucie, FL 34986 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-02 | 7736 Greenbrier cir, Port St Lucie, FL 34986 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-28 |
| LC Amendment and Name Change | 2023-03-08 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-03-05 |
| ANNUAL REPORT | 2021-03-02 |
| Florida Limited Liability | 2020-05-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
