| Entity Name: | QUINTESSENTIAL MEDICAL ASSOCIATES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 23 Mar 2022 (3 years ago) |
| Document Number: | L22000142932 |
| FEI/EIN Number | 81-2611928 |
| Address: | 537 NW LAKE WHITNEY PLACE, SUITE 103, PORT ST. LUCIE, FL 34986 |
| Mail Address: | 537 NW LAKE WHITNEY PLACE, SUITE 103, PORT ST. LUCIE, FL 34986 |
| ZIP code: | 34986 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336814177 | 2021-08-13 | 2022-05-03 | PO BOX 880854, PORT ST LUCIE, FL, 349880854, US | 573 NW LAKE WHITNEY PL STE 103, PORT ST LUCIE, FL, 349861628, US | |||||||||||||||||||
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| Phone | +1 833-245-5633 |
| Fax | 8339626213 |
Authorized person
| Name | DR. MOHAMMED J SHWEIKEH |
| Role | DOCTOR |
| Phone | 9516401941 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207QS1201X - Sleep Medicine (Family Medicine) Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| SHWEIKEH, MOHAMMED | Agent | 537 NW LAKE WHITNEY PLACE, SUITE 103, PORT ST. LUCIE, FL 34986 |
| Name | Role | Address |
|---|---|---|
| SHWEIKEH, MOHAMMED | Manager | 537 NW LAKE WHITNEY PLACE STE 103, PORT ST. LUCIE, FL 34986 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-04-18 | SHWEIKEH, MOHAMMED | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-18 | 537 NW LAKE WHITNEY PLACE, SUITE 103, PORT ST. LUCIE, FL 34986 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-18 |
| ANNUAL REPORT | 2023-04-28 |
| Florida Limited Liability | 2022-03-23 |
Date of last update: 12 Jan 2025
Sources: Florida Department of State
