| Entity Name: | IMMEDIATE CARE PRIMARY CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 Feb 2023 (2 years ago) |
| Document Number: | L23000085124 |
| FEI/EIN Number | 92-2569884 |
| Address: | 3345 JOG RD, GREENACRES, FL 33467 |
| Mail Address: | 3345 JOG RD, GREENACRES, FL 33467 |
| ZIP code: | 33467 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720835424 | 2024-05-01 | 2024-06-12 | 3345 S JOG RD, GREENACRES, FL, 334672010, US | 3345 S JOG RD, GREENACRES, FL, 334672010, US | |||||||||||||||||||||
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| Phone | +1 561-891-1830 |
| Fax | 5619657505 |
Authorized person
| Name | SHARAB MOHAMED |
| Role | PRESIDENT |
| Phone | 5618911830 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAL LICENSE NUMBER |
| Number | ME0064608 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MOHAMED, SHARAB | Agent | 3345 JOG RD, GREENACRES, FL 33467 |
| Name | Role | Address |
|---|---|---|
| MOHAMED, SHARAB | President | 3345 JOG RD, GREENACRES, FL 33467 |
| Name | Role | Address |
|---|---|---|
| MOHAMED, NEGAR | Manager | 3345 JOG RD, GREENACRES, FL 33467 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| Florida Limited Liability | 2023-02-16 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
