| Entity Name: | REGEN PRIMARY MEDICAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 16 Jul 2020 (5 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | L20000207260 |
| Address: | 8390 CHAMPIONSGATE BOULEVARD, UNIT 108, CHAMPIONSGATE, FL, 33896, US |
| Mail Address: | 8390 CHAMPIONSGATE BOULEVARD, UNIT 108, CHAMPIONSGATE, FL, 33896, US |
| ZIP code: | 33896 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508475682 | 2020-07-24 | 2020-07-24 | 8390 CHAMPIONS GATE BLVD STE 108, CHAMPIONS GATE, FL, 338968311, US | 8390 CHAMPIONS GATE BLVD STE 108, CHAMPIONS GATE, FL, 338968311, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 714-551-9576 |
Authorized person
| Name | BRYN HENDERSON |
| Role | OWNER |
| Phone | 7145519576 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HENDERSON BRYN J | Agent | 8390 CHAMPIONSGATE BOULEVARD, CHAMPIONSGATE, FL, 33896 |
| Name | Role | Address |
|---|---|---|
| PRASAD ARASI | Manager | 615 E CHAPMAN, ORANGE, CA, 92866 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2020-07-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
