| Entity Name: | PROGRESSIVE HEALTH AND REJUVENATION, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 Dec 2023 (a year ago) |
| Document Number: | L23000545477 |
| FEI/EIN Number | 93-4779980 |
| Address: | 10025 SE SANDPINE LN, HOBE SOUND, FL 33455 |
| Mail Address: | 10025 SE SANDPINE LN, HOBE SOUND, FL 33455 |
| ZIP code: | 33455 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699525626 | 2024-03-25 | 2024-03-25 | 10025 SE SANDPINE LN, HOBE SOUND, FL, 334554806, US | 3893 MILITARY TRL STE 3, JUPITER, FL, 334582936, US | |||||||||||||||
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| Phone | +1 732-881-0893 |
| Phone | +1 800-595-0577 |
Authorized person
| Name | DR. ALLAN ALBERTO CAPIN |
| Role | MEDICAL DIRECTOR |
| Phone | 7863255648 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DEWATERS, ROBERT | Agent | 10025 SE SANDPINE LN, HOBE SOUND, FL 33455 |
| Name | Role | Address |
|---|---|---|
| DEWATERS, ROBERT | Manager | 10025 SE SANDPINE LN, HOBE SOUND, FL 33455 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-13 |
| Florida Limited Liability | 2023-12-11 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
