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DIVINE HEALTH SERVICES, LLC - Florida Company Profile

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Company Details

Entity Name: DIVINE HEALTH SERVICES, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 10 Jan 2022 (4 years ago)
Document Number: L22000083554
FEI/EIN Number 88-1423550
Address: 2820 NE 214th Street, Aventura, FL, 33180, US
Mail Address: 2820 NE 214th Street, Aventura, FL, 33180, US
ZIP code: 33180
City: Miami
County: Miami-Dade
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
TONY MARIE Chief Executive Officer 2820 NE 214th Street, Aventura, FL, 33180
Balthazar Margareth IT 2820 NE 214th Street, Aventura, FL, 33180
Hong Esther Othe 2820 NE 214th Street, Aventura, FL, 33180
TONY MARIE Manager 2820 NE 214TH STREET, AVENTURA, FL, 33180
TONY MARIE PAULA Agent 2820 NE 214th Street, Aventura, FL, 33180

National Provider Identifier

NPI Number:
1376269449
Certification Date:
2022-10-19

Authorized Person:

Name:
MR. MARIE PAULA TONY
Role:
OWNER/AUTHORIZED OFFICIAL
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2023-03-28 2820 NE 214th Street, SUITE 828, Aventura, FL 33180 -
REGISTERED AGENT ADDRESS CHANGED 2023-03-28 2820 NE 214th Street, 801, Aventura, FL 33180 -
CHANGE OF PRINCIPAL ADDRESS 2022-09-20 2820 NE 214th Street, SUITE 828, Aventura, FL 33180 -

Documents

Name Date
ANNUAL REPORT 2024-02-13
ANNUAL REPORT 2023-03-28
Florida Limited Liability 2022-01-10

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Date of last update: 02 Jul 2025

Sources: Florida Department of State