| Entity Name: | 1ST CHOICE PRIMARY CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Jun 2024 (7 months ago) |
| Document Number: | L24000289340 |
| FEI/EIN Number | 993711435 |
| Address: | 275 NW MAIN STREET, SUITE B, LAKE CITY, FL, 32054, US |
| Mail Address: | 10348 SW 32ND AVE, GAINESVILLE, FL, 32608, US |
| ZIP code: | 32054 |
| County: | Union |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528806494 | 2024-07-16 | 2024-07-16 | 10348 SW 32ND AVE, GAINESVILLE, FL, 326089096, US | 275 W MAIN ST, LAKE BUTLER, FL, 320541656, US | |||||||||||||||
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| Phone | +1 352-317-3214 |
| Phone | +1 386-496-2273 |
Authorized person
| Name | JOHN DISTEFANO |
| Role | OWNER |
| Phone | 3523173214 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DISTEFANO JOHN | Agent | 10348 SW 32ND AVE, GAINESVILLE, FL, 32608 |
| Name | Role | Address |
|---|---|---|
| DISTEFANO JOHN | Manager | 10348 SW 32ND AVE, GAINESVILLE, FL, 32608 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-06-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
