| Entity Name: | FLORIDA NP HEALTHCARE CLINIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Jul 2022 (3 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 12 Sep 2022 (2 years ago) |
| Document Number: | L22000322182 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 11317 Elk Mountain Drive, RIVERVIEW, FL, 33579, US |
| Mail Address: | 6958 TOWERING SPRUCE DRIVE, RIVERVIEW, FL, 33578 |
| ZIP code: | 33579 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164128286 | 2023-01-31 | 2023-06-05 | 13117 ELK MOUNTAIN DR, RIVERVIEW, FL, 335797184, US | 13117 ELK MOUNTAIN DR, RIVERVIEW, FL, 335797184, US | |||||||||||||||
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| Phone | +1 813-898-0226 |
| Fax | 8138980239 |
Authorized person
| Name | ALICIA GRIGSBY |
| Role | APRN |
| Phone | 8138980226 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GRIGSBY ALICIA | Agent | 6958 TOWERING SPRUCE DRIVE, RIVERVIEW, FL, 33578 |
| Name | Role | Address |
|---|---|---|
| VONTARIUS MASON JR. | Manager | 6958 TOWERING SPRUCE DRIVE, RIVERVIEW, FL, 33578 |
| ALICIA GRIGSBY | Manager | 6958 TOWERING SPRUCE DRIVE, RIVERVIEW, FL, 33578 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-30 | 11317 Elk Mountain Drive, RIVERVIEW, FL 33579 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-30 | 6958 TOWERING SPRUCE DRIVE, RIVERVIEW, FL 33578 | No data |
| LC AMENDMENT | 2022-09-12 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-12 |
| LC Amendment | 2022-09-12 |
| Florida Limited Liability | 2022-07-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
