| Entity Name: | WELLNESS AND PREVENTIVE CARE OF SWFL. LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Mar 2021 (4 years ago) |
| Document Number: | L21000106987 |
| FEI/EIN Number | 862661661 |
| Address: | 5598 8TH ST W, LEHIGH ACRES, FL, 33971, US |
| Mail Address: | 5598 8TH ST W, LEHIGH ACRES, FL, 33971, US |
| ZIP code: | 33971 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346829041 | 2021-04-07 | 2021-04-07 | 112 ORTONA ST, LEHIGH ACRES, FL, 339365334, US | 5598 8TH ST W UNIT 4, LEHIGH ACRES, FL, 339713397, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 941-451-3361 |
Authorized person
| Name | MILADYS ALBOLAY IGLESIAS |
| Role | APRN |
| Phone | 9414513361 |
Taxonomy
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 105654200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ALBOLAY IGLESIAS MILADYS | Agent | 5598 8TH ST W, LEHIGH ACRES, FL, 33971 |
| Name | Role | Address |
|---|---|---|
| ALBOLAY IGLESIAS MILADYS | Manager | 5598 8TH ST W, LEHIGH ACRES, FL, 33971 |
| Name | Role | Address |
|---|---|---|
| VALDES ALBOLAY KEVIN A | Auth | 18951 PALM BEACH BLVD, ALVA, FL, 33920 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-02-11 | 5598 8TH ST W, UNIT 4, LEHIGH ACRES, FL 33971 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-11 | 5598 8TH ST W, UNIT 4, LEHIGH ACRES, FL 33971 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-05 | 5598 8TH ST W, UNIT 4, LEHIGH ACRES, FL 33971 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-21 |
| ANNUAL REPORT | 2023-02-11 |
| AMENDED ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2022-03-10 |
| Florida Limited Liability | 2021-03-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
