| Entity Name: | HERNANDO PRIMARY HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 30 Jul 2024 (6 months ago) |
| Document Number: | L24000335474 |
| Address: | 4169 LAMSON AVE, SPRING HILL, FL 34608 |
| Mail Address: | 4169 LAMSON AVE, SPRING HILL, FL 34608 |
| ZIP code: | 34608 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518793397 | 2024-09-10 | 2024-09-10 | 4169 LAMSON AVE, SPRING HILL, FL, 346083707, US | 4169 LAMSON AVE, SPRING HILL, FL, 346083707, US | |||||||||||||
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| Phone | +1 352-667-2828 |
Authorized person
| Name | KIMBERLY LE |
| Role | BILLING MANAGER |
| Phone | 3526882700 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LE, KIMBERLY | Agent | 4169 LAMSON AVE, SPRING HILL, FL 34608 |
| Name | Role | Address |
|---|---|---|
| LE, KIMBERLY | Authorized Member | 4169 LAMSON AVE, SPRING HILL, FL 34608 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-07-30 |
Date of last update: 07 Jan 2025
Sources: Florida Department of State
