| Entity Name: | MORNINGSTAR MEDICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 05 Mar 2024 (a year ago) |
| Document Number: | L24000112221 |
| Address: | 29187 POPLAR DR, PUNTA GORDA, FL 33982 |
| Mail Address: | 29187 POPLAR DR, PUNTA GORDA, FL 33982 |
| ZIP code: | 33982 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124865571 | 2024-07-12 | 2024-07-12 | 262 HALLORAN ST, PORT CHARLOTTE, FL, 339533600, US | 262 HALLORAN ST, PORT CHARLOTTE, FL, 339533600, US | |||||||||||||||||
|
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| Phone | +1 941-223-2695 |
Authorized person
| Name | BRANDY HAUSER |
| Role | OWNER |
| Phone | 9412232695 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| DANDINO, VICTORIA | Agent | 29187 POPLAR DR, PUNTA GORDA, FL 33982 |
| Name | Role | Address |
|---|---|---|
| DANDINO, VICTORIA | Manager | 29187 POPLAR DR, PUNTA GORDA, FL 33982 |
| Name | Role | Address |
|---|---|---|
| HAUSER, BRANDY | Authorized Person | 262 HALLORAN ST, PORT CHARLOTTE, FL 33953 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-03-05 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
