| Entity Name: | DOVE MEDICAL CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 03 Oct 2024 (4 months ago) |
| Document Number: | L24000427920 |
| Address: | 5600 North US Highway 27, Haines City, FL 33844 |
| Mail Address: | 5600 North US Highway 27, Haines City, FL 33844 |
| ZIP code: | 33844 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578384996 | 2024-10-18 | 2024-10-18 | PO BOX 626, LOUGHMAN, FL, 338580626, US | 9007 STINGER DR., DAVENPORT, FL, 33896, US | |||||||||||||||||||||||||
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| Phone | +1 720-737-1668 |
Authorized person
| Name | STEPHANIE RENEE DOVE |
| Role | OWNER |
| Phone | 7207371668 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 332900000X - Non-Pharmacy Dispensing Site |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| DOVE, STEPHANIE | Agent | 9007 STINGER DR, DAVENPORT, FL 33896 |
| Name | Role | Address |
|---|---|---|
| DOVE, STEPHANIE | Manager | 9007 STINGER DR, DAVENPORT, FL 33896 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-12-18 | 5600 North US Highway 27, Haines City, FL 33844 | No data |
| CHANGE OF MAILING ADDRESS | 2024-12-18 | 5600 North US Highway 27, Haines City, FL 33844 | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-10-03 |
Date of last update: 07 Feb 2025
Sources: Florida Department of State
