| Entity Name: | BESPOKE HEALTH AND WELLNESS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Feb 2024 (a year ago) |
| Document Number: | L24000075006 |
| Address: | 6605 GRANDE ORCHID WAY, DELRAY BEACH, FL, 33446 |
| Mail Address: | 6605 GRANDE ORCHID WAY, DELRAY BEACH, FL, 33446 |
| ZIP code: | 33446 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437903895 | 2024-04-12 | 2024-06-21 | 6605 GRANDE ORCHID WAY, DELRAY BEACH, FL, 334464336, US | 1500 NW 10TH AVE STE 105, BOCA RATON, FL, 334861344, US | |||||||||||||||||
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| Phone | +1 561-573-4336 |
| Phone | +1 561-717-7057 |
| Fax | 8339725610 |
Authorized person
| Name | SHARI B ROSENBAUM |
| Role | MANAGER |
| Phone | 5617177057 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GLICK SCOTT | Agent | 6853 SW 18TH ST, BOCA RATON, FL, 33433 |
| Name | Role | Address |
|---|---|---|
| ROSENBAUM SHARI M.D. | Manager | 6605 GRANDE ORCHID WAY, DELRAY BEACH, FL, 33466 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-02-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
