| Entity Name: | BREAKTHROUGH ECLINIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 10 Aug 2023 (a year ago) |
| Document Number: | L23000376284 |
| FEI/EIN Number | 93-2566401 |
| Address: | 6019 W RIO GRANDE DRIVE, BEVERLY HILLS, FL 34465 |
| Mail Address: | P.O. Box 641182, BEVERLY HILLS, FL 34464 |
| ZIP code: | 34465 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902589146 | 2023-08-14 | 2023-10-13 | 6019 W RIO GRANDE DR, BEVERLY HILLS, FL, 344652016, US | 6019 W RIO GRANDE DR, BEVERLY HILLS, FL, 344652016, US | |||||||||||||||||
|
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| Phone | +1 523-257-8843 |
Authorized person
| Name | NATHALIE GRANT |
| Role | MANAGER |
| Phone | 3523257884 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| GRANT, NATHALIE | Agent | 6019 W RIO GRANDE DR, BEVERLY HILLS, FL 34465 |
| Name | Role | Address |
|---|---|---|
| GRANT, NATHALIE | Authorized Representative | 6019 W RIO GRANDE DR, BEVERLY HILLS, FL 34465 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-01-10 | 6019 W RIO GRANDE DRIVE, BEVERLY HILLS, FL 34465 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-10 |
| Florida Limited Liability | 2023-08-10 |
Date of last update: 09 Jan 2025
Sources: Florida Department of State
