| Entity Name: | CATHOLIC PALLIATIVE CARE SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Active |
| Date Filed: | 07 Jun 2013 (12 years ago) |
| Document Number: | N13000005369 |
| FEI/EIN Number | 46-2964889 |
| Mail Address: | 4790 NORTH STATE ROAD 7, LAUDERDALE LAKES, FL 33319 |
| Address: | 14875 N.W. 77 Avenue,, Suite 100, Miami Lakes, FL 33014 |
| ZIP code: | 33014 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861822363 | 2013-11-19 | 2022-01-07 | 14875 NW 77TH AVE, SUITE 100, MIAMI LAKES, FL, 330142568, US | 14875 NW 77TH AVE, SUITE 100, MIAMI LAKES, FL, 330142568, US | |||||||||||||||
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| Phone | +1 305-351-7057 |
| Fax | 3058240665 |
Authorized person
| Name | DIAN BACKOFF |
| Role | AUTHORIZED OFFICIAL |
| Phone | 3053517100 |
Taxonomy
| Taxonomy Code | 207QH0002X - Hospice and Palliative Medicine (Family Medicine) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FITZGERALD, J. PATRICK, ESQ. | Agent | J. PATRICK FITZGERALD & ASSOCIATES, P.A., 110 MERRICK WAY, SUITE 3-B, CORAL GABLES, FL 33134 |
| Name | Role | Address |
|---|---|---|
| WORLEY, SSJ, ELIZABETH A., SR. | VCSD | ARCHDIOCESE OF MIAMI, 9401 BISCAYNE BLVD MIAMI SHORES, FL 33138 |
| Name | Role | Address |
|---|---|---|
| FRICK, MARY JO, CEO | President | CATHOLIC HEALTH SERVICES, INC., 4790 N STATE RD 7 LAUDERDALE LAKES, FL 33319 |
| Name | Role | Address |
|---|---|---|
| Lawson, Ralph E. | Chairman | 6041 NW 74 Terrace, PARKLAND, FL 33067 |
| Name | Role | Address |
|---|---|---|
| Lawson, Ralph E. | Director | 6041 NW 74 Terrace, PARKLAND, FL 33067 |
| Name | Role | Address |
|---|---|---|
| FITZGERALD, PATRICK J., ESQ. | Assistant Secretary | J. PATRICK FITZGERALD & ASSOCIATES, P.A., 110 MERRICK WAY SUITE 3B CORAL GABLES, FL 33134 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-11-02 | J. PATRICK FITZGERALD & ASSOCIATES, P.A., 110 MERRICK WAY, SUITE 3-B, CORAL GABLES, FL 33134 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-11-04 | 14875 N.W. 77 Avenue,, Suite 100, Miami Lakes, FL 33014 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-04-26 |
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-04-28 |
| AMENDED ANNUAL REPORT | 2021-11-02 |
| ANNUAL REPORT | 2021-02-03 |
| ANNUAL REPORT | 2020-02-28 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-03-21 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
