| Entity Name: | NOVA TELECLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Apr 2022 (3 years ago) |
| Document Number: | L22000178426 |
| FEI/EIN Number | 88-2122678 |
| Address: | 365 Wekiva Springs road, Longwood, FL, 32779, US |
| Mail Address: | 365 Wekiva Springs road, Longwood, FL, 32779, US |
| ZIP code: | 32779 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558009365 | 2022-05-23 | 2024-03-07 | 365 WEKIVA SPRINGS RD STE 231, LONGWOOD, FL, 327793690, US | 365 WEKIVA SPRINGS RD STE 231, LONGWOOD, FL, 327793690, US | |||||||||||||||
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| Phone | +1 321-413-1411 |
| Fax | 3213796923 |
Authorized person
| Name | ANGELA JAIMES |
| Role | PROVIDER |
| Phone | 4076028551 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BUENO RONALD | Agent | 4471 PARKBREEZE CT, ORLANDO, FL, 32802 |
| Name | Role | Address |
|---|---|---|
| JAIMES ANGELA M | Manager | 365 Wekiva Springs road, Longwood, FL, 32779 |
| HINTON ANNA C | Manager | 365 Wekiva Springs road, Longwood, FL, 32779 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-10-29 | 365 Wekiva Springs road, Suite 231, Longwood, FL 32779 | No data |
| CHANGE OF MAILING ADDRESS | 2023-10-29 | 365 Wekiva Springs road, Suite 231, Longwood, FL 32779 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-10 |
| AMENDED ANNUAL REPORT | 2023-10-29 |
| ANNUAL REPORT | 2023-01-15 |
| Florida Limited Liability | 2022-04-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
