| Entity Name: | WILDFLOWER TELEHEALTH NETWORK, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 Jun 2024 (8 months ago) |
| Document Number: | P24000039887 |
| Address: | 2443 FILLMORE STREET #380-6499, SAN FRANCISCO, CA, 94115, UN |
| Mail Address: | 2443 FILLMORE STREET #380-6499, SAN FRANCISCO, CA, 94115, UN |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861228587 | 2024-09-10 | 2024-09-10 | 2443 FILLMORE ST # 380-6499, SAN FRANCISCO, CA, 941151814, US | 1200 S PINE ISLAND RD, PLANTATION, FL, 333244413, US | |||||||||||||||||
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| Phone | +1 855-469-0506 |
Authorized person
| Name | NASH PRINCE |
| Role | SVP |
| Phone | 5164809100 |
Taxonomy
| Taxonomy Code | 163WL0100X - Lactation Consultant (Registered Nurse) |
| Is Primary | No |
| Taxonomy Code | 174N00000X - Lactation Consultant (Non-RN) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| SPARKS LEAH | Chief Executive Officer | 2443 FILLMORE STREET #380-6499, SAN FRANCISCO, CA, 94115 |
| Name | Role | Address |
|---|---|---|
| RUSSELL KIM | Chief Financial Officer | 2443 FILLMORE STREET #380-6499, SAN FRANCISCO, CA, 94115 |
| Name | Role | Address |
|---|---|---|
| TEPPEMA SARA | Secretary | 2443 FILLMORE STREET #380-6499, SAN FRANCISCO, CA, 94115 |
| Name | Date |
|---|---|
| Domestic Profit | 2024-06-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
