| Entity Name: | J.C. WELLNESS & PRIMARY CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Mar 2023 (2 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 24 Apr 2023 (2 years ago) |
| Document Number: | L23000118973 |
| FEI/EIN Number | 923003642 |
| Address: | 616 E. ALTAMONTE DR, ALTAMONTE SPRINGS, FL, 32701, US |
| Mail Address: | 616 E. ALTAMONTE DR, ALTAMONTE SPRINGS, FL, 32701, US |
| ZIP code: | 32701 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346937737 | 2023-04-18 | 2024-03-04 | 3718 GREYTHORNE LOOP, OVIEDO, FL, 327659054, US | 616 E ALTAMONTE DR STE 203, ALTAMONTE SPRINGS, FL, 327014810, US | |||||||||||||||
|
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| Phone | +1 407-701-7356 |
| Fax | 4075988830 |
Authorized person
| Name | KENISHA T. WOOD |
| Role | NURSE PRACTITIONER/ OWNER |
| Phone | 6312198520 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WOOD KENISHA T | Agent | 3718 GREYTHORNE LOOP, OVIEDO, FL, 32765 |
| Name | Role | Address |
|---|---|---|
| WOOD KENISHA | Manager | 3718 GREYTHORNE LOOP, OVIEDO, FL, 32765 |
| Name | Role | Address |
|---|---|---|
| WOOD KENISHA | Authorized Member | 3718 GREYTHORNE LOOP, OVIEDO, FL, 32765 |
| Name | Role | Address |
|---|---|---|
| Wood Kenneth SJr. | Auth | 3718 Greythorne Loop, Oviedo, FL, 32765 |
| Name | Role | Address |
|---|---|---|
| Wood Jorden T | Secretary | 3718 Greythorne Loop, Oviedo, FL, 32765 |
| Name | Role | Address |
|---|---|---|
| Wood Courtney T | Asst | 3718 Greythorne Loop, Oviedo, FL, 32765 |
| Name | Role | Address |
|---|---|---|
| Wood Kenisha | Treasurer | 3718 Greythorne Loop, Oviedo, FL, 32765 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000143466 | JC WELLNESS | ACTIVE | 2023-11-27 | 2028-12-31 | No data | 3718 GREYTHORNE LOOP, OVIEDO, FL, 32765 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-02-09 | 616 E. ALTAMONTE DR, SUITE 203, ALTAMONTE SPRINGS, FL 32701 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-02 | 616 E. ALTAMONTE DR, SUITE 203, ALTAMONTE SPRINGS, FL 32701 | No data |
| LC AMENDMENT | 2023-04-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| LC Amendment | 2023-04-24 |
| Florida Limited Liability | 2023-03-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
