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PROVIDENTIAL HEALTH SERVICES, LLC - Florida Company Profile

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Company Details

Entity Name: PROVIDENTIAL HEALTH SERVICES, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 04 Nov 2019 (6 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 17 Oct 2023 (2 years ago)
Document Number: L19000274737
FEI/EIN Number 84-3756199
Address: 4849 Lake Worth Road, SUITE 200, GREENACRES, FL, 33463, US
Mail Address: 4849 LAKE WORTH ROAD, SUITE 200, GREENACRES, FL, 33463, US
ZIP code: 33463
City: Lake Worth
County: Palm Beach
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
PIERRE LEMUEL Manager 10842 BLUE PALM STREET, PLANTATION, FL, 33324
DUFORT ALEXANDRA Manager 5541 HAVEFORD WAY, LAKE WORTH, FL, 33463
DORANTE NILA Manager 6219 ADRIATIC WAY, WEST PALM BEACH, FL, 33413
Campbell-Robinson Rhoenna E Auth 4849 LAKE WORTH ROAD, GREENACRES, FL, 33463
PIERRE LEMUEL Agent 10842 BLUE PALM STREET, PLANTATION, FL, 33324

National Provider Identifier

NPI Number:
1033755327

Authorized Person:

Name:
ALEXANDRA DUFORT
Role:
SECRETARY
Phone:

Taxonomy:

Selected Taxonomy:
253Z00000X - In Home Supportive Care Agency
Is Primary:
No
Selected Taxonomy:
251E00000X - Home Health Agency
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-04-10 4849 Lake Worth Road, SUITE 200, GREENACRES, FL 33463 -
CHANGE OF MAILING ADDRESS 2024-03-12 4849 Lake Worth Road, SUITE 200, GREENACRES, FL 33463 -
REINSTATEMENT 2023-10-17 - -
REGISTERED AGENT NAME CHANGED 2023-10-17 PIERRE, LEMUEL -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2023-09-22 - -

Documents

Name Date
ANNUAL REPORT 2024-03-12
REINSTATEMENT 2023-10-17
ANNUAL REPORT 2022-03-03
ANNUAL REPORT 2021-03-30
ANNUAL REPORT 2020-06-12
Florida Limited Liability 2019-11-04

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Date of last update: 03 Aug 2025

Sources: Florida Department of State