| Entity Name: | PURE LIFE RENAL OF WEST PALM BEACH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Oct 2018 (6 years ago) |
| Document Number: | L18000231090 |
| FEI/EIN Number | 83-2100284 |
| Address: | 1522 North Dixie Highway, West Palm Beach, FL, 33401, US |
| Mail Address: | 4000 HOLLYWOOD BLVD., SUITE 300N, HOLLYWOOD, FL, 33021, US |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013482215 | 2018-10-04 | 2020-12-30 | 4000 HOLLYWOOD BLVD STE 300N, HOLLYWOOD, FL, 330211242, US | 1522 N DIXIE HWY, WEST PALM BEACH, FL, 334012720, US | |||||||||||||
|
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| Phone | +1 954-962-5733 |
Authorized person
| Name | JEFF FERNANDEZ |
| Role | CHIEF FINANCIAL OFFICER |
| Phone | 9549625733 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CORPORATE CREATIONS NETWORK INC. | Agent |
| Name | Role |
|---|---|
| PURE LIFE RENAL, INC. | Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-25 | 801 US HIGHWAY 1, NORTH PALM BEACH, FL 33408 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-18 | 1522 North Dixie Highway, West Palm Beach, FL 33401 | No data |
| CHANGE OF MAILING ADDRESS | 2018-10-23 | 1522 North Dixie Highway, West Palm Beach, FL 33401 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-04-29 |
| ANNUAL REPORT | 2019-04-18 |
| Florida Limited Liability | 2018-10-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
