| Entity Name: | ALLEGIANCE HEALTH OF SOUTHWEST FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 29 Oct 2021 (3 years ago) |
| Document Number: | L21000470758 |
| FEI/EIN Number | 87-3383270 |
| Address: | 6750 Immokalee Suite 203, NAPLES, FL 34119 |
| Mail Address: | 6750 Immokalee Suite 203, NAPLES, FL 34119 |
| ZIP code: | 34119 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124807375 | 2023-09-27 | 2023-09-27 | 16206 CAMDEN LAKES CIR, NAPLES, FL, 341102881, US | 6750 IMMOKALEE RD UNIT 203, NAPLES, FL, 341199083, US | |||||||||||||||
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| Phone | +1 305-302-4723 |
| Phone | +1 239-359-6500 |
Authorized person
| Name | DR. ERIC CHAPMAN |
| Role | AUTHORIZED MEMBER |
| Phone | 3053024723 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CHAPMAN, ERIC | Agent | 16206 CAMDEN LAKES CIRCLE, NAPLES, FL 34110 |
| Name | Role | Address |
|---|---|---|
| CHAPMAN, ERIC | Authorized Member | 16206 CAMDEN LAKES CIRCLE, NAPLES, FL 34110 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000120519 | CHAPMAN WELLCARE | ACTIVE | 2023-09-28 | 2028-12-31 | No data | 6750 IMMOKALEE ROAD, SUITE 203, NAPLES, FL, 34119 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-12-18 | 6750 Immokalee Suite 203, NAPLES, FL 34119 | No data |
| CHANGE OF MAILING ADDRESS | 2023-12-18 | 6750 Immokalee Suite 203, NAPLES, FL 34119 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-09 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-03-07 |
| Florida Limited Liability | 2021-10-29 |
Date of last update: 13 Jan 2025
Sources: Florida Department of State
