Entity Name: | JILLIAN RUSSELL APRN LLC |
Jurisdiction: | FLORIDA |
Filing Type: |
Florida Limited Liability Co.
JILLIAN RUSSELL APRN LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
Date Filed: | 11 May 2023 (2 years ago) |
Document Number: | L23000233210 |
FEI/EIN Number |
92-3953610
Federal Employer Identification (FEI) Number assigned by the IRS. |
Address: | 5913 NE 67TH ST, SILVER SPRINGS, FL, 34488 |
Mail Address: | 5913 NE 67TH ST, SILVER SPRINGS, FL, 34488 |
ZIP code: | 34488 |
County: | Marion |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1760176341 | 2023-06-06 | 2023-06-06 | 5913 NE 67TH ST, SILVER SPRINGS, FL, 344881137, US | 5913 NE 67TH ST, SILVER SPRINGS, FL, 344881137, US | |||||||||||||||||||||||||||||
|
Phone | +1 407-670-8218 |
Authorized person
Name | MS. JILLIAN RUSSELL |
Role | PROVIDER |
Phone | 4076708218 |
Taxonomy
Taxonomy Code | 207Q00000X - Family Medicine Physician |
Is Primary | Yes |
Other Provider Identifiers
Issuer | BCBS |
Number | Q6X4V |
State | FL |
Issuer | MEDICAID |
Number | 18412200 |
State | FL |
Issuer | UHC |
Number | 0010398059 |
Name | Role | Address |
---|---|---|
RUSSELL JILLIAN E | Manager | 5913 NE 67TH ST, SILVER SPRINGS, FL, 34488 |
RUSSELL JILLIAN E | Agent | 5913 NE 67TH ST, SILVER SPRINGS, FL, 34488 |
Name | Date |
---|---|
ANNUAL REPORT | 2024-03-28 |
Florida Limited Liability | 2023-05-11 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State