| Entity Name: | PRIMARY CARE AND WELLNESS CENTERS OF CFL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Aug 2024 (5 months ago) |
| Document Number: | L24000377356 |
| Mail Address: | 1008 JULIETTE BLVD, MOUNT DORA, FL, 32757 |
| Address: | 11309 LAKE UNDERHILL RD, 104, ORLANDO, FL, 32825 |
| ZIP code: | 32825 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760203566 | 2024-10-23 | 2024-10-23 | 1008 JULIETTE BLVD, MOUNT DORA, FL, 327576500, US | 11309 LAKE UNDERHILL RD STE 104, ORLANDO, FL, 328254427, US | |||||||||||||||||
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| Phone | +1 407-450-6991 |
| Fax | 8774504723 |
| Phone | +1 850-765-6686 |
Authorized person
| Name | DR. WILLIAM FREDERICK VON BARGEN JR. |
| Role | PHYSICIAN |
| Phone | 4074506991 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VON BARGEN WILKIAM FJR | Agent | 11309 LAKE UNDERHILL RD, ORLANDO, FL, 32825 |
| Name | Role | Address |
|---|---|---|
| VON BARGEN WILLIAM FJR | Manager | 1008 JULIETTE BLVD, MOUNT DORA, FL, 32757 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-08-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
