| Entity Name: | YOUR SUPREME HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 15 Oct 2021 (3 years ago) |
| Document Number: | L21000450321 |
| FEI/EIN Number | 87-3136572 |
| Address: | 1451 W CYPRESS CREEK ROAD, FT LAUDERDALE, FL, 33309, US |
| Mail Address: | 1451 W CYPRESS CREEK ROAD, FT LAUDERDALE, FL, 33309, US |
| ZIP code: | 33309 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972261253 | 2021-12-03 | 2021-12-03 | 92 NE 49TH ST, MIAMI, FL, 331373116, US | 92 NE 49TH ST, MIAMI, FL, 331373116, US | |||||||||||||||||
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| Phone | +1 786-439-6990 |
Authorized person
| Name | PAULINE HENRY |
| Role | MM |
| Phone | 7864396990 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| HENRY PAULINE | Agent | 92 N.E. 49 ST, MIAMI, FL, 33137 |
| Name | Role | Address |
|---|---|---|
| HENRY PAULINE | Manager | 92 N.E. 49 ST., MIAMI, FL, 33137 |
| HILL DARNITA | Manager | 1650 SOUTH FOX RUN APT 831, OPELIKA, AL, 36801 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-02-15 | 1451 W CYPRESS CREEK ROAD, STE 300, FT LAUDERDALE, FL 33309 | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-15 | 1451 W CYPRESS CREEK ROAD, STE 300, FT LAUDERDALE, FL 33309 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-15 |
| ANNUAL REPORT | 2023-04-17 |
| ANNUAL REPORT | 2022-04-29 |
| Florida Limited Liability | 2021-10-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
