| Entity Name: | EHEALTH PROVISIONS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 09 Feb 2023 (2 years ago) |
| Document Number: | L23000073614 |
| FEI/EIN Number | 92-2461462 |
| Address: | 1435 SOUTH OSPREY AVENUE, SUITE 200, SARASOTA, FL 34239 |
| Mail Address: | 1435 SOUTH OSPREY AVENUE, SUITE 200, SARASOTA, FL 34239 |
| ZIP code: | 34239 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821797622 | 2023-03-01 | 2024-10-14 | 1435 S OSPREY AVE STE 200, SARASOTA, FL, 342392905, US | 1435 S OSPREY AVE STE 200, SARASOTA, FL, 342392905, US | |||||||||||||||||||||
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| Phone | +1 941-298-0045 |
| Fax | 9412793145 |
| Phone | +1 941-404-5453 |
Authorized person
| Name | KIM LILLY THOMSON |
| Role | AUTHORIZED REP /NURSE PRACTITIONER |
| Phone | 9412980045 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FLORIDA HEALTHCARE LAW FIRM | Agent | 151 NW 1ST AVENUE, DELRAY BEACH, FL 33444 |
| Name | Role | Address |
|---|---|---|
| THOMSON, KIM LILLY | Authorized Member | 4360 47TH STREET, SARASOTA, FL 34235 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-26 |
| AMENDED ANNUAL REPORT | 2024-09-06 |
| ANNUAL REPORT | 2024-02-27 |
| Florida Limited Liability | 2023-02-09 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
