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PRACTICE WELLNESS LLC - Florida Company Profile

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Company Details

Entity Name: PRACTICE WELLNESS LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 15 Oct 2024 (10 months ago)
Document Number: L24000440206
FEI/EIN Number 33-2265869
Address: 4945 SOUTH ORANGE BLOSSOM TRAIL, ORLANDO, FL, 32839, US
Mail Address: 5081 NW 121ST DRIVE, CORAL SPRINGS, FL, 33076, UN
ZIP code: 32839
City: Orlando
County: Orange
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
LUJAN LUIS F Chief Executive Officer 4945 SOUTH ORANGE BLOSSOM TRAIL, ORLANDO, FL, 32839
IZQUIERDO ERIC Chief Operating Officer 4945 SOUTH ORANGE BLOSSOM TRAIL, ORLANDO, FL, 32839
LUJAN LUIS F Agent 4945 SOUTH ORANGE BLOSSOM TRAIL, ORLANDO, FL, 32839

National Provider Identifier

NPI Number:
1194533745
Certification Date:
2025-01-16

Authorized Person:

Name:
LUIS F LUJAN
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2025-01-16 4945 SOUTH ORANGE BLOSSOM TRAIL, SUITE 6, ORLANDO, FL 32839 -
REGISTERED AGENT ADDRESS CHANGED 2025-01-16 4945 SOUTH ORANGE BLOSSOM TRAIL, SUITE 6, ORLANDO, FL 32839 -

Documents

Name Date
ANNUAL REPORT 2025-01-16
Florida Limited Liability 2024-10-15

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Date of last update: 02 Aug 2025

Sources: Florida Department of State