| Entity Name: | PROVIDENCE MEDICAL FOUNDATION INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Not For Profit Corporation |
| Status: | Active |
| Date Filed: | 10 Mar 2022 (3 years ago) |
| Document Number: | F22000001452 |
| FEI/EIN Number | 33-0185031 |
| Address: | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Mail Address: | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Place of Formation: | CALIFORNIA |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Barcellona, William | Director | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Bartlett, Connie , DO | Director | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Benoit, James Dr. | Director | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Currie, Jeannette , MD | Director | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Ford, Anne , MD | Director | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Marquez, Raul , MD | Director | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Marter, Roscoe | Director | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Marton, Keith , MD | Director | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Needham, Mark | Director | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Santore, Ali | Director | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Name | Role | Address |
|---|---|---|
| Watson, James D. | Secretary | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Name | Role | Address |
|---|---|---|
| Yocum , Connie Melayne | Chief Financial Officer | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Name | Role | Address |
|---|---|---|
| MOHANTY, PRASANNA | PRESIDENT | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Name | Role | Address |
|---|---|---|
| PARDOE, MARK | DIRECTOR | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| CHAN, KIMBERLEY | DIRECTOR | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| DUPLECHAN, JILL | DIRECTOR | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| FERREY, ANTONIO | DIRECTOR | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| MAST, DAVID | DIRECTOR | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-20 | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-20 | 200 W. Center Street Promenade, Suite 800, Anaheim, CA 92805 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-02-20 |
| Foreign Non-Profit | 2022-03-10 |
Date of last update: 12 Jan 2025
Sources: Florida Department of State
