| Entity Name: | SALUS MEDICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 01 Jun 2021 (4 years ago) |
| Document Number: | L21000254446 |
| FEI/EIN Number | 87-1001733 |
| Mail Address: | 11661 MEADOW GROVE CIR, ORLANDO, FL 32836 |
| Address: | 11661 Meadow Grove Circle, Orlando, FL 32836 |
| ZIP code: | 32836 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366019812 | 2021-06-04 | 2021-06-04 | 11661 MEADOW GROVE CIR, ORLANDO, FL, 328365049, US | 7824 LAKE UNDERHILL RD STE A, ORLANDO, FL, 328228201, US | |||||||||||||||||||||
|
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| Phone | +1 407-282-2001 |
Authorized person
| Name | LUISA M NIEVES |
| Role | LEAD PHYSICIAN |
| Phone | 7873992999 |
Taxonomy
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QI0500X - Infusion Therapy Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| NIEVES, LUISA M, MD | Agent | 11661 MEADOW GROVE CIR, ORLANDO, FL 32836 |
| Name | Role | Address |
|---|---|---|
| NIEVES, LUISA M, MD | Authorized Person | 11661 MEADOW GROVE CIR, ORLANDO, FL 32836 |
| Name | Role | Address |
|---|---|---|
| MARTINEZ, JOSE R | Manager | 11661 MEADOW GROVE CIR, ORLANDO, FL 32836 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-05-03 | 11661 Meadow Grove Circle, Orlando, FL 32836 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-23 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-05-03 |
| Florida Limited Liability | 2021-06-01 |
Date of last update: 13 Feb 2025
Sources: Florida Department of State
