| Entity Name: | WELLNESS360 PRIMARY CARE CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 25 Mar 2024 (10 months ago) |
| Document Number: | P24000021745 |
| Address: | 1700 SE HILLMOOR DRIVE, SUITE 305, PORT SAINT LUCIE, FL 34952 |
| Mail Address: | 1700 SE HILLMOOR DRIVE, SUITE 305, PORT SAINT LUCIE, FL 34952 |
| ZIP code: | 34952 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154172773 | 2024-04-01 | 2024-04-01 | 1700 SE HILLMOOR DR STE 305, PORT SAINT LUCIE, FL, 349527536, US | 1700 SE HILLMOOR DR STE 305, PORT SAINT LUCIE, FL, 349527536, US | |||||||||||||
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| Phone | +1 772-292-8188 |
Authorized person
| Name | YOHANNA DENO |
| Role | OWNER |
| Phone | 7646702685 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MORALES, MASSIEL, APRN | Agent | 1700 SE HILLMOOR DRIVE, SUITE 305, PORT SAINT LUCIE, FL 34952 |
| Name | Role | Address |
|---|---|---|
| DENO, YOHANNA, MD | President | 11209 SW STOCKTON PLACE, PORT SAINT LUCIE, FL 34987 |
| MORALES, MASSIEL, APRN | President | 1213 SW SAN ANTONIO AVENUE, PORT SAINT LUCIE, FL 34953 |
| Name | Date |
|---|---|
| Domestic Profit | 2024-03-25 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
