| 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 | |||||||||||||||||||||||||||||
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| 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
