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DYNAMIC PRIMARY HEALTHCARE CLINIC, INC. - Florida Company Profile

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Company Details

Entity Name: DYNAMIC PRIMARY HEALTHCARE CLINIC, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 11 Feb 2022 (4 years ago)
Last Event: AMENDMENT
Event Date Filed: 28 Mar 2022 (3 years ago)
Document Number: P22000012908
FEI/EIN Number 88-0814463
Address: 163 SW STONEGATE TERRACE, SUITE 109, LAKE CITY, FL, 32024
Mail Address: 924 SE LANTANA LOOP, LAKE CITY, FL, 32025, UN
ZIP code: 32024
City: Lake City
County: Columbia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
BROWN CATHERINE Agent 924 SE LANTANA LOOP, LAKE CITY, FL, 32025
BROWN CATHERINE R President 924 SE LANTANA LOOP, LAKE CITY, FL, 32025
BROWN THOMAS J Vice President 924 SE LANTANA LOOP, LAKE CITY, FL, 32025
BROWN THOMAS J Secretary 924 SE LANTANA LOOP, LAKE CITY, FL, 32025
BROWN THOMAS J Treasurer 924 SE LANTANA LOOP, LAKE CITY, FL, 32025

Unique Entity ID

Unique Entity ID:
F87DE442MZF8
UEI Expiration Date:
2025-05-05

Business Information

Doing Business As:
DYNAMIC HEALTH CENTERS
Activation Date:
2024-05-07
Initial Registration Date:
2024-05-05

National Provider Identifier

NPI Number:
1710633144
Certification Date:
2024-03-18

Authorized Person:

Name:
JOHN DISTEFANO
Role:
BUSINESS MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G22000034968 DYNAMIC HEALTH CENTERS ACTIVE 2022-03-17 2027-12-31 - 924 SE LANTANA LOOP, LAKE CITY, FL, 32025

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2023-04-03 BROWN, CATHERINE -
AMENDMENT 2022-03-28 - -

Documents

Name Date
ANNUAL REPORT 2024-04-19
ANNUAL REPORT 2023-04-03
Amendment 2022-03-28
Off/Dir Resignation 2022-03-09
Domestic Profit 2022-02-11

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Date of last update: 03 Aug 2025

Sources: Florida Department of State