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BERNADETTE PREMIUM HEALTHCARE LLC - Florida Company Profile

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Company Details

Entity Name: BERNADETTE PREMIUM HEALTHCARE LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 01 Jul 2020 (5 years ago)
Document Number: L20000185915
FEI/EIN Number 85-1897988
Address: 919 PARK AVENUE, LAKE PARK, FL, 33403, US
Mail Address: 332 blasam street, Palm Beach Gardens, FL, 33410, US
ZIP code: 33403
City: West Palm Beach
County: Palm Beach
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
DATIS MARIE Manager 332 blasam street, Palm Beach Gardens, FL, 33410
DATIS DATHNEY Vice President 332 blasam street, Palm Beach Gardens, FL, 33410
DATIS MARIE V Agent 2546 CANTERBURY DRIVE, SOUTH RIVIERA, FL, 33407

National Provider Identifier

NPI Number:
1730707175
Certification Date:
2020-07-13

Authorized Person:

Name:
MRS. MARIE VERONIQUE DATIS
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QD1600X - Developmental Disabilities Clinic/Center
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-04-23 919 PARK AVENUE, LAKE PARK, FL 33403 -
CHANGE OF MAILING ADDRESS 2024-04-23 919 PARK AVENUE, LAKE PARK, FL 33403 -

Documents

Name Date
ANNUAL REPORT 2024-04-23
ANNUAL REPORT 2023-02-01
ANNUAL REPORT 2022-03-22
ANNUAL REPORT 2021-01-29
Florida Limited Liability 2020-07-01

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Date of last update: 02 Aug 2025

Sources: Florida Department of State