| Entity Name: | PRACTITIONERS HEALTHCARE NETWORK, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Feb 2013 (12 years ago) |
| Document Number: | L13000018960 |
| FEI/EIN Number | 46-1996349 |
| Address: | 4788 W COMMERCIAL BLVD, TAMARAC, FL, 33319, US |
| Mail Address: | 4788 W COMMERCIAL BLVD, TAMARAC, FL, 33319, US |
| ZIP code: | 33319 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669925590 | 2016-07-27 | 2016-07-27 | 4788 W COMMERCIAL BLVD, TAMARAC, FL, 333192878, US | 9540 HUDSON ST, MIRAMAR, FL, 330254208, US | |||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||
| Phone | +1 954-668-0287 |
| Fax | 9546401455 |
Authorized person
| Name | MRS. DIANE JOHN |
| Role | PRESIDENT |
| Phone | 9546680287 |
Taxonomy
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| License Number | 3112112 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | 3112112 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 313M00000X - Nursing Facility/Intermediate Care Facility |
| License Number | 3112112 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| JOHN DIANE | Agent | 4788 W COMMERCIAL BLVD, TAMARAC, FL, 33319 |
| Name | Role | Address |
|---|---|---|
| JOHN DIANE | Managing Member | 4788 W COMMERCIAL BLVD, TAMARAC, FL, 33319 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2014-01-08 | 4788 W COMMERCIAL BLVD, TAMARAC, FL 33319 | No data |
| CHANGE OF MAILING ADDRESS | 2014-01-08 | 4788 W COMMERCIAL BLVD, TAMARAC, FL 33319 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-08 | 4788 W COMMERCIAL BLVD, TAMARAC, FL 33319 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-28 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-02-14 |
| ANNUAL REPORT | 2018-02-08 |
| ANNUAL REPORT | 2017-01-07 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-01-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
