| Entity Name: | SALVEO MEDICINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Jul 2024 (6 months ago) |
| Document Number: | L24000326556 |
| Address: | 335 BARBADOS DRIVE, PONTE VEDRA, FL, 32081, US |
| Mail Address: | 335 BARBADOS DRIVE, PONTE VEDRA, FL, 32081, US |
| ZIP code: | 32081 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487488110 | 2024-08-27 | 2024-11-07 | 485 STATE ROAD 13 N STE 2, SAINT JOHNS, FL, 322592993, US | 6100 GREENLAND RD STE 903, JACKSONVILLE, FL, 322587450, US | |||||||||||||||||||||||||||||||
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| Phone | +1 239-293-8403 |
| Fax | 2392938403 |
Authorized person
| Name | RYAN D POLING |
| Role | OWNER |
| Phone | 2392938403 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 2083B0002X - Obesity Medicine (Preventive Medicine) Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | FLORIDA BOARD OF MEDICINE |
| Number | ME142810 |
| State | FL |
| Issuer | MEDICAID |
| Number | 105061000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| POLING RYAN DR. | Agent | 335 BARBADOS DRIVE, PONTE VEDRA, FL, 32081 |
| Name | Role | Address |
|---|---|---|
| POLING RYAN DR. | Manager | 335 BARBADOS DRIVE, PONTE VEDRA, FL, 32081 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-07-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
