| Entity Name: | ALLIANCE HEALTHCARE & WELLNESS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 04 Nov 2020 (4 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L20000349867 |
| FEI/EIN Number | 85-3904753 |
| Address: | 21401 CORKSCREW VILLAGE LANE UNIT 1, ESTERO, FL 33929 |
| Mail Address: | 1441 Saint Clair Rd, Englewood, FL 34223 |
| ZIP code: | 33929 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043804180 | 2021-03-01 | 2021-03-01 | 21401 CORKSCREW VILLAGE LN STE 1, ESTERO, FL, 339281915, US | 21401 CORKSCREW VILLAGE LN STE 1, ESTERO, FL, 339281915, US | |||||||||||||
|
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| Phone | +1 727-309-1412 |
Authorized person
| Name | DONNA GLOTZ |
| Role | CREDENTIALING SPECIALIST |
| Phone | 4402625185 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Farag, Anne Marie L | Agent | 1441 Saint Clair Rd, Englewood, FL 34223 |
| Name | Role | Address |
|---|---|---|
| FARAG, NAGY | Authorized Representative | 1441 Saint Clair Rd, Englewood, FL 34223 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-31 | 21401 CORKSCREW VILLAGE LANE UNIT 1, ESTERO, FL 33929 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-31 | 21401 CORKSCREW VILLAGE LANE UNIT 1, ESTERO, FL 33929 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-31 | 1441 Saint Clair Rd, Englewood, FL 34223 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-04-28 | Farag, Anne Marie L | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-03-31 |
| ANNUAL REPORT | 2021-04-28 |
| Florida Limited Liability | 2020-11-04 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
