| Entity Name: | PURAVITA IV LOUNGE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Feb 2021 (4 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 09 Aug 2021 (4 years ago) |
| Document Number: | L21000068206 |
| FEI/EIN Number | 87-1546306 |
| Address: | 890 Livestock Loop, Saint Cloud, FL, 34771, US |
| Mail Address: | 890 Livestock Loop, Saint Cloud, FL, 34771, US |
| ZIP code: | 34771 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386479277 | 2024-09-03 | 2024-09-03 | 890 LIVESTOCK LOOP, SAINT CLOUD, FL, 347719146, US | 890 LIVESTOCK LOOP, SAINT CLOUD, FL, 347719146, US | |||||||||||||
|
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| Phone | +1 407-212-0860 |
Authorized person
| Name | MS. CARLA DARNETT FUENTES-BLANCO |
| Role | CEO |
| Phone | 4072120860 |
Taxonomy
| Taxonomy Code | 251F00000X - Home Infusion Agency |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FUENTES BLANCO CARLA D | Agent | 890 Livestock Loop, Saint Cloud, FL, 34771 |
| Name | Role | Address |
|---|---|---|
| FUENTES-BLANCO CARLA | Authorized Member | 890 Livestock Loop, Saint Cloud, FL, 34771 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000101057 | CDF CLINIC | ACTIVE | 2024-08-26 | 2029-12-31 | No data | 890 LIVESTOCK LOOP, SAINT CLOUD, FL, 34771 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-15 | FUENTES BLANCO , CARLA D | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-18 | 890 Livestock Loop, Saint Cloud, FL 34771 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-18 | 890 Livestock Loop, Saint Cloud, FL 34771 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-18 | 890 Livestock Loop, Saint Cloud, FL 34771 | No data |
| LC AMENDMENT | 2021-08-09 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-15 |
| ANNUAL REPORT | 2023-02-18 |
| ANNUAL REPORT | 2022-04-22 |
| LC Amendment | 2021-08-09 |
| Florida Limited Liability | 2021-02-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
