| Entity Name: | STORMY'S PRIMARY CARE AND WELLNESS MEDSPA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Jan 2022 (3 years ago) |
| Document Number: | L22000040053 |
| FEI/EIN Number | 87-4820711 |
| Address: | 20200 W DIXIE HWY, 805B, MIAMI, FL, 33180, US |
| Mail Address: | 400 LESLIE DRIVE, 1014, HALLANDALE BEACH, FL, 33009, UN |
| ZIP code: | 33180 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639823040 | 2022-02-05 | 2022-04-04 | 400 LESLIE DR APT 1014, HALLANDALE BEACH, FL, 330092910, US | 20200 W DIXIE HWY STE 805B, MIAMI, FL, 331801920, US | |||||||||||||||
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| Phone | +1 786-809-1855 |
| Fax | 3059908832 |
Authorized person
| Name | STORMY GALE MCBRIDE |
| Role | APRN/OWNER |
| Phone | 3059348667 |
Taxonomy
| Taxonomy Code | 363LG0600X - Gerontology Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MCBRIDE STORMY | Agent | 400 LESLIE DRIVE, HALLANDALE BEACH, FL, 33009 |
| Name | Role | Address |
|---|---|---|
| MCBRIDE STORMY G | Authorized Representative | 400 LESLIE DRIVE, 1014, HALLANDALE BEACH, FL, 33009 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-26 | 20200 W DIXIE HWY, 805B, MIAMI, FL 33180 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-26 |
| ANNUAL REPORT | 2023-02-17 |
| Florida Limited Liability | 2022-01-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
