| Entity Name: | EVOLVE MEDICAL LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 30 Sep 2022 (2 years ago) |
| Document Number: | L22000424369 |
| FEI/EIN Number | 92-0564726 |
| Address: | 24 N Tarragona Street, PENSACOLA, FL 32502 |
| Mail Address: | 5865 Dandelion Lane, Pensacola, FL 32526 |
| ZIP code: | 32502 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427760800 | 2022-12-19 | 2022-12-19 | 1716 DONEGAL DR, CANTONMENT, FL, 325338997, US | 22 N TARRAGONA ST, PENSACOLA, FL, 325026063, US | |||||||||||||||||
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| Phone | +1 850-207-9086 |
| Phone | +1 850-292-6623 |
| Fax | 8503661333 |
Authorized person
| Name | KAITLIN GRAYE |
| Role | CEO |
| Phone | 8502079086 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GRAYE, KAITLIN | Agent | 5865 DANDELION LN, PENSACOLA, FL 32526 |
| Name | Role | Address |
|---|---|---|
| GRAYE, KAITLIN | President | 5865 DANDELION LN, PENSACOLA, FL 32526 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000125003 | THE COLLECTIVE AT 24 N | ACTIVE | 2023-10-09 | 2028-12-31 | No data | 22 N TARRAGONA STREET, PENSACOLA, FL, 32502 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-01 | 5865 DANDELION LN, PENSACOLA, FL 32526 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-25 | 24 N Tarragona Street, PENSACOLA, FL 32502 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-19 | 24 N Tarragona Street, PENSACOLA, FL 32502 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-01-19 |
| Florida Limited Liability | 2022-09-30 |
Date of last update: 11 Jan 2025
Sources: Florida Department of State
