| Entity Name: | HEALTHCARE EXTRAORDINARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Nov 2020 (4 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 01 Feb 2021 (4 years ago) |
| Document Number: | L20000355785 |
| FEI/EIN Number | 861299937 |
| Address: | 1532 Kingsley Ave, SUITE 109, Orange Park, FL, 32073, US |
| Mail Address: | 1532 Kingsley Ave, SUITE 109, 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 | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780273474 | 2021-01-16 | 2021-01-16 | 3154 HIGHLAND GROVE DR, ORANGE PARK, FL, 320656855, US | 3154 HIGHLAND GROVE DR, ORANGE PARK, FL, 320656855, US | |||||||||||||||
|
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| Phone | +1 904-613-6974 |
| Fax | 9043752012 |
Authorized person
| Name | DR. TANA ROBINSON |
| Role | DNP/APRN |
| Phone | 9046133974 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ROBINSON TANA | Agent | 3154 HIGHLAND GROVE DR, ORANGE PARK, FL, 32065 |
| Name | Role | Address |
|---|---|---|
| ROBINSON TANA | Manager | 3154 HIGHLAND GROVE DR., ORANGE PARK, FL, 32065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-02-15 | 1532 Kingsley Ave, SUITE 109, Orange Park, FL 32073 | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-15 | 1532 Kingsley Ave, SUITE 109, Orange Park, FL 32073 | No data |
| LC AMENDMENT | 2021-02-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-24 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-02-15 |
| LC Amendment | 2021-02-01 |
| Florida Limited Liability | 2020-11-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
