| Entity Name: | TOTAL CARE LONGEVITY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 19 Dec 2023 (a year ago) |
| Document Number: | L23000557494 |
| FEI/EIN Number | 93-4920063 |
| Address: | 213 N FEDERAL HIGHWAY, HALLANDALE BEACH, FL 33009 |
| Mail Address: | 213 N FEDERAL HIGHWAY, HALLANDALE BEACH, FL 33009 |
| ZIP code: | 33009 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770354805 | 2024-01-09 | 2024-01-09 | 213 N FEDERAL HWY, HALLANDALE BEACH, FL, 330094342, US | 213 N FEDERAL HWY, HALLANDALE BEACH, FL, 330094342, US | |||||||||||||||||||||||
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| Phone | +1 305-466-4357 |
| Fax | 3054664358 |
Authorized person
| Name | DR. BRAD A KERN |
| Role | PRESIDENT |
| Phone | 3054664357 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207XX0005X - Sports Medicine (Orthopaedic Surgery) Physician |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| KERN, BRAD A | Agent | 213 N FEDERAL HIGHWAY, HALLANDALE BEACH, FL 33009 |
| Name | Role | Address |
|---|---|---|
| KERN, BRAD | Director | 213 N FEDERAL HIGHWAY, HALLANDALE BEACH, FL 33009 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| Florida Limited Liability | 2023-12-19 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
