| Entity Name: | VITAL HEALTH CONCIERGE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Jun 2023 (2 years ago) |
| Document Number: | L23000266737 |
| FEI/EIN Number | 93-1797241 |
| Address: | 15418 FIRE ROCK PL, RUSKIN, FL, 33573, US |
| Mail Address: | 15418 FIRE ROCK PL, RUSKIN, FL, 33573, US |
| ZIP code: | 33573 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669245064 | 2023-11-07 | 2023-11-07 | 15418 FIRE ROCK PL, RUSKIN, FL, 335730196, US | 325 S PARSONS AVE, BRANDON, FL, 335115228, US | |||||||||||||||||||||||||||
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| Phone | +1 813-545-0133 |
| Phone | +1 813-397-6779 |
Authorized person
| Name | JENNA MADHAVAN |
| Role | CO-OWNER/APRN |
| Phone | 8135450133 |
Taxonomy
| Taxonomy Code | 251F00000X - Home Infusion Agency |
| Is Primary | No |
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VICKERS DOMONIQUE D | Agent | 15418 FIRE ROCK PL, RUSKIN, FL, 33573 |
| Name | Role | Address |
|---|---|---|
| VICKERS DOMONIQUE D | Manager | 15418 FIRE ROCK PL, RUSKIN, FL, 33573 |
| MADHAVAN JENNA | Manager | 11506 LEANNE LANE, TAMPA, FL, 33637 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| Florida Limited Liability | 2023-06-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
