| Entity Name: | BELFIORE WELLNESS CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Sep 2020 (4 years ago) |
| Document Number: | L20000287440 |
| FEI/EIN Number | 85-3113645 |
| Address: | 502 E. Hickory Ave, CRESTVIEW, FL, 32439, US |
| Mail Address: | 502 E. HICKORY AVE, CRESTVIEW, FL, 32436, US |
| ZIP code: | 32439 |
| County: | Walton |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144836446 | 2020-09-22 | 2020-12-07 | 502 E HICKORY AVE, CRESTVIEW, FL, 325362742, US | 502 E HICKORY AVE, CRESTVIEW, FL, 325362742, US | |||||||||||||||||||
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| Phone | +1 850-683-1100 |
| Fax | 8506830599 |
Authorized person
| Name | KRISTINA SMITH |
| Role | MBR |
| Phone | 2566773295 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Smith Kristina | Agent | 502 E. Hickory Ave, CRESTVIEW, FL, 32439 |
| Name | Role | Address |
|---|---|---|
| MOORE CHRISTINE C | Authorized Member | 5639 PARK PLACE, CRESTVIEW, FL, 32539 |
| SMITH KRISTINA D | Authorized Member | 181 Fairway Xing, FREEPORT, FL, 32439 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-03-01 | Smith, Kristina | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-01 | 502 E. Hickory Ave, CRESTVIEW, FL 32439 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-11-13 | 502 E. Hickory Ave, CRESTVIEW, FL 32439 | No data |
| CHANGE OF MAILING ADDRESS | 2020-11-13 | 502 E. Hickory Ave, CRESTVIEW, FL 32439 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-19 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-03-01 |
| ANNUAL REPORT | 2021-03-25 |
| Florida Limited Liability | 2020-09-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
