| Entity Name: | AXEL HEALTH PRIMARY CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Mar 2021 (4 years ago) |
| Document Number: | L21000119028 |
| FEI/EIN Number | 86-2832080 |
| Address: | 4820 GRIFFIN BLVD, FORT MYERS, FL, 33908 |
| Mail Address: | 4820 GRIFFIN BLVD, FORT MYERS, FL, 33908 |
| ZIP code: | 33908 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700463643 | 2021-03-26 | 2023-08-10 | 6811 PORTO FINO CIR, FORT MYERS, FL, 339124354, US | 6811 PORTO FINO CIR, FORT MYERS, FL, 339124354, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 239-208-6648 |
| Fax | 2399310221 |
Authorized person
| Name | SUMEET SHETTY |
| Role | CEO |
| Phone | 2392086648 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAL LICENSE |
| Number | ME91067 |
| Name | Role |
|---|---|
| AXEL HEALTH LLC | Agent |
| Name | Role |
|---|---|
| AXEL HEALTH LLC | Manager |
| Name | Role |
|---|---|
| GMD RO & CO PLLC | Authorized Member |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-02-02 |
| Florida Limited Liability | 2021-03-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
