| Entity Name: | VIDA PLUS MEDICAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Jun 2022 (3 years ago) |
| Document Number: | L22000283977 |
| FEI/EIN Number | 882920111 |
| Address: | 339 Cypress Parkway, KISSIMMEE, FL, 34759, US |
| Mail Address: | 3105 CRISPIN CIR, SAINT CLOUD, FL, 34773, US |
| ZIP code: | 34759 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992424832 | 2022-08-24 | 2022-08-24 | 339 CYPRESS PKWY STE 250, KISSIMMEE, FL, 347593315, US | 339 CYPRESS PKWY STE 250, KISSIMMEE, FL, 347593315, US | |||||||||||||||
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| Phone | +1 407-910-1555 |
| Fax | 4079101577 |
Authorized person
| Name | EDWIN NIEVES |
| Role | CEO |
| Phone | 7873630406 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| NIEVES HERNANDEZ EDWIN J | Agent | 3105 CRISPIN CIR, SAINT CLOUD, FL, 34773 |
| Name | Role | Address |
|---|---|---|
| NIEVES HERNANDEZ EDWIN J | Authorized Member | 3105 CRISPIN CIR, SAINT CLOUD, FL, 34773 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-10-26 | 339 Cypress Parkway, SUITE 250, KISSIMMEE, FL 34759 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-01-19 |
| Florida Limited Liability | 2022-06-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
