| Entity Name: | 100 PHYSICIANS MEDICINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 06 Jan 2022 (3 years ago) |
| Document Number: | L22000005587 |
| FEI/EIN Number | 85-2574890 |
| Address: | 17495 SE 74TH RAES HALL AVE., THE VILLAGES, FL 32162 |
| Mail Address: | 17495 SE 74TH RAES HALL AVE., THE VILLAGES, FL 32162 |
| ZIP code: | 32162 |
| County: | Sumter |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407508930 | 2022-01-26 | 2022-01-26 | 17495 SE 74TH RAES HALL AVE, THE VILLAGES, FL, 321625352, US | 13721 N US HIGHWAY 441 STE 2, LADY LAKE, FL, 321598910, US | |||||||||||||||
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| Phone | +1 505-900-1476 |
| Phone | +1 352-254-5544 |
Authorized person
| Name | DR. MIGUEL J DE PUIGDORFILA |
| Role | MANAGING DIRECTOR |
| Phone | 5059001476 |
Taxonomy
| Taxonomy Code | 171100000X - Acupuncturist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MIGUEL DE PUIGDORFILA | Agent | 17495 SE 74TH RAES HALL AVE., THE VILLAGES, FL 32162 |
| Name | Role | Address |
|---|---|---|
| MIGUEL DE PUIGDORFILA | Member | 17495 SE 74TH RAES HALL AVE., THE VILLAGES, FL 32162 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-10 |
| ANNUAL REPORT | 2024-01-21 |
| ANNUAL REPORT | 2023-01-29 |
| Florida Limited Liability | 2022-01-06 |
Date of last update: 12 Feb 2025
Sources: Florida Department of State
