| Entity Name: | PRIME CARE HEALTH AGENCY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Nov 1985 (39 years ago) |
| Document Number: | M23344 |
| FEI/EIN Number | 592596595 |
| Address: | 7951 SW 6th Street, Plantation, FL, 33324, US |
| Mail Address: | 7951 SW 6th Street, Plantation, FL, 33324, US |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477556751 | 2005-05-31 | 2019-07-10 | 11440 N KENDALL DR STE 500, MIAMI, FL, 331761025, US | 11440 N KENDALL DR STE 500, MIAMI, FL, 331761025, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-591-7774 |
| Fax | 3055948951 |
Authorized person
| Name | MRS. MARIA GRIECO |
| Role | ADMINISTRATOR |
| Phone | 3055917774 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | HHA20960096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 027021103 |
| State | FL |
| Issuer | MEDICAID |
| Number | 678246900 |
| State | FL |
| Issuer | BCBS |
| Number | JO6 |
| State | FL |
| Issuer | MEDICAID |
| Number | 027021100 |
| State | FL |
| Issuer | MEDICAID |
| Number | 027021196 |
| State | FL |
| Issuer | MEDICAID |
| Number | 027021101 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Valletti Gaston H | Agent | 7951 SW 6th Street, Plantation, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| Valletti Gaston H | Director | 7951 SW 6th Street, Plantation, FL, 33324 |
| NICOLINI NATALIA | Director | 7951 SW 6th Street, Plantation, FL, 33324 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000054522 | PRINCIPLE HEALTH SERVICES | ACTIVE | 2016-06-02 | 2026-12-31 | No data | 7951 SW 6TH STREET, STE 106, PLANTATION, FL, 33324 |
| G09000115453 | PRINCIPLE HEALTH SERVICES | EXPIRED | 2009-06-09 | 2014-12-31 | No data | 8405 NW 53RD STREET, SUITE B-106, MIAMI, FL, 33166 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
