| Entity Name: | WASHINGTON HILLS PRIMARY CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 11 Sep 2020 (4 years ago) |
| Document Number: | L20000284369 |
| FEI/EIN Number | 85-2965262 |
| Address: | 1532 Kingsley Avenue Suite 101, ORANGE PARK, FL, 32073, US |
| Mail Address: | 1532 Kingsley Avenue Suite 101, ORANGE PARK, FL, 32073, US |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205441615 | 2020-09-11 | 2021-03-19 | 4645 PLANTATION OAKS BLVD, ORANGE PARK, FL, 320653652, US | 4645 PLANTATION OAKS BLVD, ORANGE PARK, FL, 320653652, US | |||||||||||||
|
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| Phone | +1 904-505-7566 |
Authorized person
| Name | REGINA IMARI WASHINGTON |
| Role | NURSE PRACTITIONER |
| Phone | 9045057566 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WASHINGTON REGINA I | Agent | 4645 PLANTATION OAKS BLVD, ORANGE PARK, FL, 32065 |
| Name | Role | Address |
|---|---|---|
| WASHINGTON REGINA I | Authorized Representative | 4645 PLANTATION OAKS BLVD, ORANGE PARK, FL, 32065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-06-19 | 1532 Kingsley Avenue Suite 101, ORANGE PARK, FL 32073 | No data |
| CHANGE OF MAILING ADDRESS | 2024-06-19 | 1532 Kingsley Avenue Suite 101, ORANGE PARK, FL 32073 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-02-15 |
| Florida Limited Liability | 2020-09-11 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
