| Entity Name: | AWAKEN HEALTH DIRECT PRIMARY CARE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Feb 2023 (2 years ago) |
| Document Number: | L23000071325 |
| FEI/EIN Number | 922722308 |
| Address: | 12525 Orange Drive, Davie, FL, 33330, US |
| Mail Address: | 12525 Orange Drive, Davie, FL, 33330, US |
| ZIP code: | 33330 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801676267 | 2023-10-03 | 2023-10-03 | 12525 ORANGE DR STE 710, DAVIE, FL, 333304308, US | 12525 ORANGE DR STE 710, DAVIE, FL, 333304308, US | |||||||||||||
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| Phone | +1 954-646-6911 |
Authorized person
| Name | FLORENCIA GOLUBOFF |
| Role | OWNER |
| Phone | 9546466911 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role |
|---|---|
| BENJAMIN LAW PRACTICE, PLLC | Agent |
| Name | Role | Address |
|---|---|---|
| BENJAMIN MICHELE L | Manager | 16020 SOUTH POST RD #204, WESTON, FL, 33331 |
| GOLUBOFF FLORENCIA | Manager | 15810 NW 11TH STREET, PEMBROKE PINES, FL, 33028 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-11-20 | 12525 Orange Drive, Suite 710, Davie, FL 33330 | No data |
| CHANGE OF MAILING ADDRESS | 2023-11-20 | 12525 Orange Drive, Suite 710, Davie, FL 33330 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| Florida Limited Liability | 2023-02-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
