| Entity Name: | PRIMARY PHYSICIAN RESOURCE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 12 Apr 2023 (2 years ago) |
| Document Number: | L23000181517 |
| FEI/EIN Number | 92-3456702 |
| Address: | 330 SW 27 AVENUE, 403-B, MIAMI, FL 33135 |
| Mail Address: | PO BOX 430764, MIAMI, FL 33243 |
| ZIP code: | 33135 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003504531 | 2023-04-24 | 2023-04-25 | PO BOX 430764, MIAMI, FL, 332430764, US | 330 SW 27TH AVE STE 403B, MIAMI, FL, 331352967, US | |||||||||||||
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| Phone | +1 786-348-2589 |
Authorized person
| Name | KRISTIANE VILLALVAZO-GONZALEZ |
| Role | MANAGING MEMBER |
| Phone | 7863482589 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VILLALVAZO-GONZALEZ, KRISTIANE | Agent | 330 SW 27 AVENUE, SUITE 403-B, MIAMI, FL 33135 |
| Name | Role | Address |
|---|---|---|
| VILLALVAZO-GONZALEZ, KRISTIANE | Manager | 330 SW 27 AVENUE, SUITE 403-B, FL 33135 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| Florida Limited Liability | 2023-04-12 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
