| Entity Name: | COMPLECARE WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 Aug 2021 (3 years ago) |
| Document Number: | L21000380542 |
| FEI/EIN Number | 87-2350368 |
| Address: | 9900 W SAMPLE RD, CORAL SPRINGS, FL, 33065, US |
| Mail Address: | 8801 West Atlantic Blvd, Coral Springs, FL, 33071, US |
| ZIP code: | 33065 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467129304 | 2021-08-27 | 2024-05-19 | 8801 W ATLANTIC BLVD # 773714, CORAL SPRINGS, FL, 330717462, US | 9900 W SAMPLE RD STE 300, CORAL SPRINGS, FL, 330654077, US | |||||||||||||||||||||
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| Phone | +1 954-866-0810 |
| Fax | 8775520946 |
| Fax | 8775520976 |
Authorized person
| Name | DR. ROSELINE RAPHAEL |
| Role | CEO/NURSE PRACTITIONER |
| Phone | 9548660810 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RAPHAEL ROSELINE | Agent | 8801 West Atlantic Blvd, Coral Springs, FL, 33071 |
| Name | Role | Address |
|---|---|---|
| RAPHAEL ROSELINE | Authorized Person | 8801 West Atlantic Blvd, Coral Springs, FL, 33071 |
| Name | Role | Address |
|---|---|---|
| RAPHAEL WILFRED | Manager | 8801 West Atlantic Blvd, Coral Springs, FL, 33071 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000038444 | RENEWED VITAL CARE | ACTIVE | 2024-03-16 | 2029-12-31 | No data | 9900 W.SAMPLE ROAD SUITE 300, CORAL SPRINGS, FL, 33065 |
| G24000008051 | RENEWED VITAL | ACTIVE | 2024-01-13 | 2029-12-31 | No data | 8801 WEST ATLANTIC BLVD #773714, CORAL SPRINGS, FL, 33077 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-29 | 9900 W SAMPLE RD, SUITE 300, CORAL SPRINGS, FL 33065 | No data |
| CHANGE OF MAILING ADDRESS | 2023-12-10 | 9900 W SAMPLE RD, SUITE 300, CORAL SPRINGS, FL 33065 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-12-10 | 8801 West Atlantic Blvd, 773714, Coral Springs, FL 33071 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| AMENDED ANNUAL REPORT | 2023-12-10 |
| ANNUAL REPORT | 2023-04-16 |
| ANNUAL REPORT | 2022-04-30 |
| Florida Limited Liability | 2021-08-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
