| Entity Name: | PHOENIX HEALTH ASCENDENCY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 22 May 2023 (2 years ago) |
| Document Number: | M23000007144 |
| FEI/EIN Number |
923648109
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 17011 STATE RD 50 STE 103, CLERMONT, FL, 34711 |
| Mail Address: | 17011 STATE RD 50 STE 103, CLERMONT, FL, 34711 |
| ZIP code: | 34711 |
| County: | Lake |
| Place of Formation: | WYOMING |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336837665 | 2023-04-25 | 2023-05-05 | 17011 STATE ROAD 50 STE 103, CLERMONT, FL, 347118203, US | 17011 STATE ROAD 50 STE 103, CLERMONT, FL, 347118203, US | |||||||||||||||||||||||||||||||||||
|
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| Phone | +1 323-695-3822 |
Authorized person
| Name | HEATHER DIAZ |
| Role | ADMINISTRATOR |
| Phone | 3236953822 |
Taxonomy
| Taxonomy Code | 207KA0200X - Allergy Physician |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | No |
| Taxonomy Code | 2080A0000X - Pediatric Adolescent Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 277908100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Smith Matt | Owne | 17011 STATE RD 50 STE 103, CLERMONT, FL, 34711 |
| SEPE AL | Agent | 1801 NE 123 ST STE 314, N MIAMI, FL, 33181 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-21 |
| Foreign Limited | 2023-05-22 |
Date of last update: 02 Mar 2025
Sources: Florida Department of State
