| Entity Name: | VITACORE MEDICAL GROUP, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 18 Jul 2023 (2 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 11 Oct 2023 (a year ago) |
| Document Number: | L23000340290 |
| FEI/EIN Number | 93-2465534 |
| Address: | 870 N. Miramar Ave., Unit #233, Indialantic, FL 32903 |
| Mail Address: | 870 N. Miramar Ave., Unit #233, Indialantic, FL 32903 |
| ZIP code: | 32903 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720866213 | 2023-09-18 | 2024-01-09 | 870 N MIRAMAR AVE UNIT 233, INDIALANTIC, FL, 329033054, US | 223 PEREGRINE DRIVE, INDIALANTIC, FL, 32903, US | |||||||||||||||
|
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| Phone | +1 321-292-2740 |
| Fax | 8784531836 |
Authorized person
| Name | MICHAEL WILLIAM STAINTON |
| Role | OWNER |
| Phone | 3212922740 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| STAINTON, MICHAEL W | Agent | 870 N. Miramar Ave., Unit #233, Indialantic, FL 32903 |
| Name | Role | Address |
|---|---|---|
| STAINTON, MICHAEL W | Authorized Member | 223 PEREGRINE DRIVE, INDIALANTIC, FL 32903 |
| THE MICHAEL W. STAINTON AND STEPHANIE A. STAINTON JOINT LIVING TRUST | Authorized Member | 223 PEREGRINE DRIVE, INDIALANTIC, FL 32903 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000130707 | REFLECTIONS MEDICAL WEIGHT LOSS | ACTIVE | 2023-10-23 | 2028-12-31 | No data | 223 PEREGRINE DRIVE, INDIALANTIC, FL, 32903 |
| G23000087147 | VITACORE HEALTH AND WELLNESS | ACTIVE | 2023-07-25 | 2028-12-31 | No data | 223 PEREGRINE DRIVE, INDIALANTIC, FL, 32903 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-02 | 870 N. Miramar Ave., Unit #233, Indialantic, FL 32903 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-02 | 870 N. Miramar Ave., Unit #233, Indialantic, FL 32903 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-02 | 870 N. Miramar Ave., Unit #233, Indialantic, FL 32903 | No data |
| LC AMENDMENT | 2023-10-11 | No data | No data |
| LC AMENDMENT | 2023-08-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| LC Amendment | 2023-10-11 |
| LC Amendment | 2023-08-28 |
| Florida Limited Liability | 2023-07-18 |
Date of last update: 09 Jan 2025
Sources: Florida Department of State
