| Entity Name: | BARIWELL LIFESTYLE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 22 Jan 2024 (a year ago) |
| Document Number: | L24000039858 |
| Address: | 130 CORRIDOR RD, 704, PONTE VEDRA, FL 32004 |
| Mail Address: | 130 CORRIDOR RD, 704, PONTE VEDRA, FL 32004 |
| ZIP code: | 32004 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366203689 | 2024-01-23 | 2024-01-23 | 130 CORRIDOR RD UNIT 704, PONTE VEDRA, FL, 320047729, US | 782 NOCATEE VILLAGE DR, PONTE VEDRA BEACH, FL, 320810280, US | |||||||||||||
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| Phone | +1 954-829-8822 |
Authorized person
| Name | MRS. GINA ROSENBERG |
| Role | DIETITIAN |
| Phone | 9548298822 |
Taxonomy
| Taxonomy Code | 133V00000X - Registered Dietitian |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ROSENBERG, GINA | Agent | 130 CORRIDOR RD, 704, PONTE VEDRA, FL 32004 |
| Name | Role | Address |
|---|---|---|
| ROSENBERG, RANDY | Vice President | 130 CORRIDOR RD #704, PONTE VEDRA, FL 32004 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-01-22 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
