| Entity Name: | VITAL FOR LIFE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 04 Jun 2001 (24 years ago) |
| Document Number: | N01000003812 |
| FEI/EIN Number | 651112031 |
| Mail Address: | 7351 W. OAKLAND PARK BLVD, LAUDERHILL, FL, 33319, US |
| Address: | 7351 W. OAKLAND PARK BLVD, LAUDERHILL, FL, 33319, US |
| ZIP code: | 33319 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972813020 | 2010-10-07 | 2022-02-15 | 7351 WEST OAKLAND PARK BLVD, STE 101, LAUDERHILL, FL, 333191041, US | 7351 WEST OAKLAND PARK BLVD, STE 101, LAUDERHILL, FL, 333191041, US | |||||||||||||||||||||||||
|
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| Phone | +1 954-748-9744 |
| Fax | 9542087416 |
Authorized person
| Name | APRIL RYMER |
| Role | CLINICAL DIRECTOR |
| Phone | 9547489744 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 6897304 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MCCORMICK APRIL | Agent | 7351 W. OAKLAND PARK BLVD, LAUDERHILL, FL, 33319 |
| Name | Role | Address |
|---|---|---|
| RYMER VICTOR | Director | 7351 W. OAKLAND PARK BLVD, LAUDERHILL, FL, 33319 |
| Name | Role | Address |
|---|---|---|
| MCCORMICK APRIL | President | 7351 W. OAKLAND PARK BLVD, LAUDERHILL, FL, 33319 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-20 | 7351 W. OAKLAND PARK BLVD, Suite 103, LAUDERHILL, FL 33319 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-20 | 7351 W. OAKLAND PARK BLVD, Suite 103, LAUDERHILL, FL 33319 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-20 | 7351 W. OAKLAND PARK BLVD, Suite 103, LAUDERHILL, FL 33319 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-04-29 | MCCORMICK, APRIL | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-20 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-02-17 |
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-06-23 |
| ANNUAL REPORT | 2018-02-08 |
| ANNUAL REPORT | 2017-04-13 |
| ANNUAL REPORT | 2016-02-21 |
| ANNUAL REPORT | 2015-02-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
