| Entity Name: | PREMIER CARE CENTRE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Jul 2020 (5 years ago) |
| Last Event: | LC AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 20 Oct 2020 (4 years ago) |
| Document Number: | L20000200337 |
| FEI/EIN Number | 854012453 |
| Address: | 2050 Havendale Blvd NW, Winter Haven, FL, 33881, US |
| Mail Address: | 2050 Havendale Blvd NW, Winter Haven, FL, 33881, US |
| ZIP code: | 33881 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518564699 | 2020-10-02 | 2023-09-15 | 2050 HAVENDALE BLVD NW STE B, WINTER HAVEN, FL, 338813828, US | 2050 HAVENDALE BLVD NW STE B, WINTER HAVEN, FL, 338813828, US | |||||||||||||||||||||||||||||
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| Phone | +1 863-268-2211 |
| Fax | 8632229343 |
Authorized person
| Name | CHRISTA LORGEAT |
| Role | DNP, APRN |
| Phone | 8632507260 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1336571116 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LORGEAT CHRISTA | Agent | 2050 Havendale Blvd NW, Winter Haven, FL, 33881 |
| Name | Role | Address |
|---|---|---|
| LORGEAT CHRISTA | Authorized Member | 2050 Havendale Blvd NW, Winter Haven, FL, 33881 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G25000000108 | DACS MEDICAL WELLNESS & AESTHETICS | ACTIVE | 2025-01-02 | 2030-12-31 | No data | 2050 HAVENDALE BLVD NW STE B, WINTER HAVEN, FL, 33881 |
| G24000092120 | DACS HEALTHCARE TRAINING CENTER | ACTIVE | 2024-08-02 | 2029-12-31 | No data | 2050 HAVENDALE BLVD, NW, STE B, WINTER HAVEN, FL, 33881 |
| G24000074018 | PREMIER CARE CENTRE INSTITUTE | ACTIVE | 2024-06-14 | 2029-12-31 | No data | 2050 HAVENDALE BLVD NW UNIT B, WINTER HAVEN, FL, 33881 |
| G20000134633 | FAMILY HOLISTIC WELLNESS | ACTIVE | 2020-10-16 | 2025-12-31 | No data | 2050 HAVENDALE BLVD NW UNIT B, WINTER HAVEN, FL, 33881 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-06 | 2050 Havendale Blvd NW, B, Winter Haven, FL 33881 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-06 | 2050 Havendale Blvd NW, B, Winter Haven, FL 33881 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-06 | 2050 Havendale Blvd NW, B, Winter Haven, FL 33881 | No data |
| LC AMENDMENT AND NAME CHANGE | 2020-10-20 | PREMIER CARE CENTRE LLC | No data |
| REGISTERED AGENT NAME CHANGED | 2020-10-20 | LORGEAT, CHRISTA | No data |
| LC AMENDMENT AND NAME CHANGE | 2020-09-02 | PREMIER HEALTHCARE CENTRE LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-01-06 |
| ANNUAL REPORT | 2021-01-31 |
| LC Amendment and Name Change | 2020-09-02 |
| Florida Limited Liability | 2020-07-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
