| Entity Name: | ADVANCE PRACTICE PRACTITIONER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 01 Jul 2022 (3 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 04 Nov 2024 (3 months ago) |
| Document Number: | L22000296649 |
| FEI/EIN Number | 88-3097230 |
| Address: | 8526 NEMOURS PKWY, ORLANDO, FL 32827 |
| Mail Address: | 8526 NEMOURS PKWY, ORLANDO, FL 32827 |
| ZIP code: | 32827 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114795721 | 2023-12-13 | 2023-12-13 | 8526 NEMOURS PKWY, ORLANDO, FL, 328277752, US | 8526 NEMOURS PKWY, ORLANDO, FL, 328277752, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-993-0542 |
Authorized person
| Name | MR. ALLISTAIR MCDONALD SMITH |
| Role | CEO/PHYSICIAN ASSISTANT |
| Phone | 9549930542 |
Taxonomy
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | Yes |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1952884389 |
| State | FL |
| Issuer | NA |
| Number | 1932682432 |
| State | FL |
| Issuer | NA |
| Number | 1952884389 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1932682432 |
| State | FL |
| Name | Role |
|---|---|
| LEGALINC CORPORATE SERVICES INC. | Agent |
| Name | Role | Address |
|---|---|---|
| SMITH, ALLISTAIR | Authorized Member | 8526 NEMOURS PKWY, ORLANDO, FL 32827 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-11-04 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-11-04 | LEGALINC CORPORATE SERVICES INC. | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-12-06 | 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-11-04 |
| Florida Limited Liability | 2022-07-01 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
