| Entity Name: | SUNRISE FAMILY PRACTICE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Aug 2022 (2 years ago) |
| Document Number: | L22000366792 |
| FEI/EIN Number | 88-4015925 |
| Address: | 255NE 19TH DRIVE, OKEECHOBEE, FL, 34972, US |
| Mail Address: | 830 SE 25TH STREET, OKEECHOBEE, FL, 34974, US |
| ZIP code: | 34972 |
| County: | Okeechobee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669180881 | 2022-11-07 | 2022-11-07 | 255 NE 19TH DR, OKEECHOBEE, FL, 349721933, US | 255 NE 19TH DR, OKEECHOBEE, FL, 349721933, US | |||||||||||||||
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| Phone | +1 863-467-8398 |
| Fax | 8634679850 |
Authorized person
| Name | SUNITA DHILLON |
| Role | NURSE PRACTIONER |
| Phone | 8634678398 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DHILLON SUNITA | Agent | 830 SE 25TH STREET, OKEECHOBEE, FL, 34974 |
| Name | Role | Address |
|---|---|---|
| DHILLON SUNITA | Authorized Member | 830 SE 25TH STREET, OKEECHOBEE, FL, 34974 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-11-14 | 255NE 19TH DRIVE, OKEECHOBEE, FL 34972 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-04-30 |
| Florida Limited Liability | 2022-08-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
