| Entity Name: | MAGNOLIA HOLISTIC FAMILY MEDICINE PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 31 May 2023 (2 years ago) |
| Document Number: | L23000263853 |
| FEI/EIN Number | 93-1680313 |
| Address: | 7562 WHISPERWOOD DR, PANAMA CITY, FL 32404 |
| Mail Address: | 7562 WHISPERWOOD DR, PANAMA CITY, FL 32404 |
| ZIP code: | 32404 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669150421 | 2023-07-10 | 2023-07-10 | 7562 WHISPERWOOD DR, PANAMA CITY, FL, 324042413, US | 7562 WHISPERWOOD DR, PANAMA CITY, FL, 324042413, US | |||||||||||||
|
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| Phone | +1 850-890-6482 |
Authorized person
| Name | CHARLY BARKER |
| Role | NURSE PRACTITIONER |
| Phone | 8508906482 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| LEGALINC CORPORATE SERVICES INC. | Agent |
| Name | Role | Address |
|---|---|---|
| BARKER, CHARLY | Authorized Member | 7562 WHISPERWOOD DR, PANAMA CITY, FL 32404 |
| HUNTER, HEATHER | Authorized Member | 2044 3 PUTT LN, PANAMA CITY, FL 32404 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-21 |
| Florida Limited Liability | 2023-05-31 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
