| Entity Name: | ELEVATE PRIMARY CARE & WELLNESS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 May 2024 (9 months ago) |
| Document Number: | L24000228255 |
| Address: | 107 LAKE EMMA COVE DR, LAKE MARY, FL 32746 |
| Mail Address: | 107 LAKE EMMA COVE DR, LAKE MARY, FL 32746 |
| ZIP code: | 32746 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336986827 | 2024-07-11 | 2024-07-15 | 107 LAKE EMMA COVE DR, LAKE MARY, FL, 327462508, US | 107 LAKE EMMA COVE DR, LAKE MARY, FL, 327462508, US | |||||||||||||
|
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| Phone | +1 407-310-3102 |
Authorized person
| Name | DR. NELA F BALLESTEROS MOYANO |
| Role | MEDICAL DIRECTOR |
| Phone | 4073103102 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BALLESTEROS, NELA | Agent | 107 LAKE EMMA COVE DR, LAKE MARY, FL 32746 |
| Name | Role | Address |
|---|---|---|
| BALLESTEROS, NELA | Manager | 107 LAKE EMMA COVE DR, LAKE MARY, FL 32746 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-05-16 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
