| Entity Name: | TREE OF LIFE FAMILY MEDICINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 03 Sep 2024 (5 months ago) |
| Document Number: | L24000383502 |
| Address: | 718 MUSTANG COURT, WINTER SPRINGS, FL 32708 |
| Mail Address: | 718 MUSTANG COURT, WINTER SPRINGS, FL 32708 |
| ZIP code: | 32708 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831924968 | 2024-09-06 | 2024-09-06 | 718 MUSTANG CT, WINTER SPRINGS, FL, 327084512, US | 718 MUSTANG CT, WINTER SPRINGS, FL, 327084512, US | |||||||||||||||
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| Phone | +1 407-865-2716 |
| Fax | 4075428050 |
Authorized person
| Name | ADRIEL PEREZ |
| Role | OWNER |
| Phone | 4078652716 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PEREZ, ADRIEL | Agent | 718 MUSTANG COURT, WINTER SPRINGS, FL 32708 |
| Name | Role | Address |
|---|---|---|
| PEREZ, ADRIEL | Manager | 718 MUSTANG COURT, WINTER SPRINGS, FL 32708 |
| Name | Role | Address |
|---|---|---|
| PEREZ, RACHEL N | Vice President | 718 MUSTANG COURT, WINTER SPRINGS, FL 32708 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-09-03 |
Date of last update: 07 Feb 2025
Sources: Florida Department of State
