| Entity Name: | PATIENT CARE MEDICAL GROUP FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Apr 2023 (2 years ago) |
| Document Number: | M23000005112 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 26 MAIN STREET, EDISON, NJ, 08837, US |
| Mail Address: | 26 MAIN STREET, EDISON, NJ, 08837, US |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326826876 | 2023-09-18 | 2023-09-18 | 26 MAIN ST, EDISON, NJ, 088373418, US | 3800 TOWN CTR BLVD, ORLANDO, FL, 328376196, US | |||||||||||||||||||||||||
|
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| Phone | +1 407-505-4602 |
Authorized person
| Name | ANDREW PECORA |
| Role | OWNERE |
| Phone | 6097440050 |
Taxonomy
| Taxonomy Code | 133V00000X - Registered Dietitian |
| Is Primary | No |
| Taxonomy Code | 183500000X - Pharmacist |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207QG0300X - Geriatric Medicine (Family Medicine) Physician |
| Is Primary | No |
| Name | Role |
|---|---|
| VCORP AGENT SERVICES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| PECORA DR. ANDREW | Member | 26 MAIN STREET, EDISON, NJ, 08837 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-09 |
| Foreign Limited | 2023-04-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
