| Entity Name: | ATHENA ADULT PRIMARY CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Sep 2022 (2 years ago) |
| Document Number: | L22000390102 |
| FEI/EIN Number | 92-0245123 |
| Address: | 1425 Viscaya Pkwy, CAPE CORAL, FL, 33990, US |
| Mail Address: | 1425 Viscaya Pkwy, CAPE CORAL, FL, 33990, US |
| ZIP code: | 33990 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558083105 | 2022-09-12 | 2024-07-09 | 118 SW 13TH TER, CAPE CORAL, FL, 339918024, US | 1425 VISCAYA PKWY STE 102, CAPE CORAL, FL, 339903294, US | |||||||||||||
|
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| Phone | +1 239-471-2775 |
Authorized person
| Name | ZAHILY PERAZA-HIGGINS |
| Role | CEO |
| Phone | 2394712775 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HIGGINS ROBERT | Agent | 1425 Viscaya Pkwy, CAPE CORAL, FL, 33990 |
| Name | Role | Address |
|---|---|---|
| PERAZA-HIGGINS ZAHILY | Authorized Member | 1425 Viscaya Pkwy, CAPE CORAL, FL, 33990 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000082743 | CABO AESTHETICS | ACTIVE | 2023-07-13 | 2028-12-31 | No data | 118 SW 13TH TERRACE, CAPE CORAL, FL, 33991 |
| G23000047299 | LIFESYNERGY WELLNESS | ACTIVE | 2023-04-13 | 2028-12-31 | No data | 1425 VISCAYA PKWY, SUITE 102, CAPE CORAL, FL, 33990 |
| G23000011302 | VITALITY CENTER OF CAPE CORAL | ACTIVE | 2023-01-24 | 2028-12-31 | No data | 1425 VISCAYA PKWY, CAPE CORAL, FL, 33990 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-12 | 1425 Viscaya Pkwy, 102, CAPE CORAL, FL 33990 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-12 | 1425 Viscaya Pkwy, 102, CAPE CORAL, FL 33990 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-12 | 1425 Viscaya Pkwy, 102, CAPE CORAL, FL 33990 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-10 |
| ANNUAL REPORT | 2023-02-12 |
| Florida Limited Liability | 2022-09-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
