| Entity Name: | PRIMARY CARE OF OC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 15 Feb 2024 (a year ago) |
| Document Number: | L24000081682 |
| FEI/EIN Number | 991460621 |
| Address: | 135 E MINNESOTA AVE, ORANGE CITY, FL, 32763, US |
| Mail Address: | 341 W MINNESOTA AVE, ORANGE CITY, FL, 32763, US |
| ZIP code: | 32763 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790541456 | 2024-02-21 | 2024-02-21 | 341 W MINNESOTA AVE, ORANGE CITY, FL, 327632205, US | 135 E MINNESOTA AVE, ORANGE CITY, FL, 327632312, US | |||||||||||||||
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| Phone | +1 386-316-5439 |
| Fax | 8336711039 |
Authorized person
| Name | VALMA CROKER |
| Role | CEO |
| Phone | 3862148047 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CROKER VALMA | Agent | 341 W MINNESOTA AVE, ORANGE CITY, FL, 32763 |
| Name | Role | Address |
|---|---|---|
| CROKER VALMA | Chief Executive Officer | 341 W MINNESOTA AVE, ORANGE CITY, FL, 32763 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-02-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
