| Entity Name: | PRO HEALTH HERITAGE SQUARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 21 Dec 2012 (12 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | L12000159207 |
| FEI/EIN Number | 46-1608032 |
| Mail Address: | 3100 17 street, St. Cloud, FL 34769 |
| Address: | 819 EAST OAK STREET, SUITE A, KISSIMMEE, FL 34744 |
| ZIP code: | 34744 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801132386 | 2013-01-02 | 2013-04-04 | 2301 NW 33RD CT, SUITE 11, POMPANO BEACH, FL, 330691000, US | 901 E OAK ST, SUITE A, KISSIMMEE, FL, 347445837, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 954-586-8058 |
| Fax | 9542831083 |
| Phone | +1 561-843-7720 |
Authorized person
| Name | JOSEPH J. DICAPUA |
| Role | MGRM |
| Phone | 5618437720 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME0069080 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | ME19806 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| DI CAPUA, JOSEPH J | Agent | 3100 17 street, St. Cloud, FL 34769 |
| Name | Role | Address |
|---|---|---|
| Di Capua, Joseph J | Managing Member | 3100 17 Street, St. Cloud, FL 34769 |
| Name | Role | Address |
|---|---|---|
| POWERS, CHARLES, Dr. | Manager | 3100 17TH STREET, ST. CLOUD, FL 34769 |
| Blanco, Frank E | Manager | 3100 17 street, St. Cloud, FL 34769 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2014-01-10 | 819 EAST OAK STREET, SUITE A, KISSIMMEE, FL 34744 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-10 | 3100 17 street, St. Cloud, FL 34769 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-01-10 |
| ANNUAL REPORT | 2013-04-29 |
| Florida Limited Liability | 2012-12-21 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
