| Entity Name: | PALM BEACH PRIMARY CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 27 Oct 2023 (a year ago) |
| Document Number: | L23000491274 |
| FEI/EIN Number | 93-4124418 |
| Address: | 14151 LITTLE CYPRESS CIRCLE, WEST PALM BEACH 33410 FL |
| Mail Address: | 14151 LITTLE CYPRESS CIRCLE, WEST PALM BEACH 33410 FL |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225800584 | 2023-10-30 | 2023-10-30 | 14151 LITTLE CYPRESS CIR, WEST PALM BEACH, FL, 334101118, US | 14151 LITTLE CYPRESS CIR, WEST PALM BEACH, FL, 334101118, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 561-531-8943 |
Authorized person
| Name | ANDRES DOMINGUEZ |
| Role | CEO |
| Phone | 5615318943 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DOMINGUEZ, ANDRES | Agent | 14151 LITTLE CYPRESS CIRCLE, WEST PALM BEACH, FL 33410 |
| Name | Role | Address |
|---|---|---|
| DOMINGUEZ, ANDRES | Manager | 14151 LITTLE CYPRESS CIRCLE, WEST PALM BEACH, FL 33410 UN |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-24 |
| Florida Limited Liability | 2023-10-27 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
