| Entity Name: | LIVING WATER WELLNESS CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 02 Oct 2023 (a year ago) |
| Document Number: | L23000454335 |
| FEI/EIN Number | 934059890 |
| Address: | 2194 HWY A1A, SUITE 206, INDIAN HARBOUR BEACH, FL, 32937, US |
| Mail Address: | 274 E. EAU GALLIE BLVD, SUITE 306, INDIAN HARBOUR BEACH, FL, 32937, US |
| ZIP code: | 32937 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134991177 | 2023-10-24 | 2024-02-06 | 274 E EAU GALLIE BLVD # 306, INDIAN HARBOUR BEACH, FL, 329374874, US | 2194 HIGHWAY A1A STE 206, INDIAN HARBOUR BEACH, FL, 329374931, US | |||||||||||||||||
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| Phone | +1 321-448-2924 |
| Fax | 3213011073 |
| Fax | 3212565283 |
Authorized person
| Name | ALEJANDRO PEREZ |
| Role | PROVIDER MANAGER |
| Phone | 3059053042 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role |
|---|---|
| URS AGENTS, LLC | Agent |
| Name | Role |
|---|---|
| CNP HEALTH, INC. | Authorized Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-26 | 2194 HWY A1A, SUITE 206, INDIAN HARBOUR BEACH, FL 32937 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| Florida Limited Liability | 2023-10-02 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
